L’albumine en chirurgie cardiaque adulte : un compte rendu narratif

Hanley, Ciara; Callum, Jeannie; Karkouti, Keyvan; Bartoszko, Justyna

doi:10.1007/s12630-021-01991-7

Cited by 18 publications

(8 citation statements)

References 126 publications

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“…Finally, it is important to highlight that HA fluid therapy is not associated with greater degradation of the glycocalyx than Gelofusine, which is currently the most widely used colloid in cardiopulmonary bypass. Although high-quality randomized studies are still lacking to clarify the indications for albumin in cardiac surgery with CPB, the existing studies demonstrated its efficacy and safety of use [ 9 , 18 ]. Pesonen et al did not find a difference for major adverse events over the following 90 days in a recent randomized monocentric study comparing 4% albumin and ringer acetate as a CPB prime.…”

Section: Discussionmentioning

confidence: 99%

Priming of Cardiopulmonary Bypass with Human Albumin Decreases Endothelial Dysfunction after Pulmonary Ischemia–Reperfusion in an Animal Model

Selim

Hamzaoui

Ghemired

et al. 2022

IJMS

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The routine use of mechanical circulatory support during lung transplantation (LTx) is still controversial. The use of prophylactic human albumin (HA) or hypertonic sodium lactate (HSL) prime in mechanical circulatory support during LTx could prevent ischemia–reperfusion (IR) injuries and pulmonary endothelial dysfunction and thus prevent the development of pulmonary graft dysfunction. The objective was to investigate the impact of cardiopulmonary bypass (CPB) priming with HA and HSL compared to a CPB prime with Gelofusine (GF) on pulmonary endothelial dysfunction in a lung IR rat model. Rats were assigned to four groups: IR-CPB-GF group, IR-CPB-HA group, IR-CPB-HSL group and a sham group. The study of pulmonary vascular reactivity by wire myograph was the primary outcome. Glycocalyx degradation (syndecan-1 and heparan) was also assessed by ELISA and electron microscopy, systemic and pulmonary inflammation by ELISA (IL-1β, IL-10, and TNF-α) and immunohistochemistry. Clinical parameters were evaluated. We employed a CPB model with three different primings, permitting femoral–femoral assistance with left pulmonary hilum ischemia for IR. Pulmonary endothelium-dependent relaxation to acetylcholine was significantly decreased in the IR-CPB-GF group (11.9 ± 6.2%) compared to the IR-CPB-HA group (52.8 ± 5.2%, p < 0.0001), the IR-CPB-HSL group (57.7 ± 6.3%, p < 0.0001) and the sham group (80.8 ± 6.5%, p < 0.0001). We did not observe any difference between the groups concerning glycocalyx degradation, and systemic or tissular inflammation. The IR-CPB-HSL group needed more vascular filling and developed significantly more pulmonary edema than the IR-CPB-GF group and the IR-CPB-HA group. Using HA as a prime in CPB during Ltx could decrease pulmonary endothelial dysfunction’s IR-mediated effects. No effects of HA were found on inflammation.

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Section: Discussionmentioning

confidence: 99%

Priming of Cardiopulmonary Bypass with Human Albumin Decreases Endothelial Dysfunction after Pulmonary Ischemia–Reperfusion in an Animal Model

Selim

Hamzaoui

Ghemired

et al. 2022

IJMS

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“…A low lymphocyte count may indicate a weakened immune system, resulting in an increased susceptibility to pathogenic cortisol. In addition, decreased lymphocytes may occur from elevated cortisol levels, which may have a deleterious effect on the prognosis of SVR [24] . Low albumin concentrations in the serum may be an indicator of renal and hepatic failure as well as low nutritional condition.…”

Section: Discussionmentioning

confidence: 99%

Low Prognostic Nutritional Index Contributes to High Risk of Adverse Events in Patients Undergoing Surgical Valve Replacement

Lian

Yao

Zheng

et al. 2022

Preprint

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Background Prognostic nutritional index (PNI) score is a useful indicator to evaluate the nutritional status of patients. However, the nutritional significance of the PNI score and its ability to predict clinical prognosis in patients with surgical valve replacement (SVR) are unknown. The goal of this study was to analyze the association between PNI on admission and adverse events in patients following SVR.Methods This study included 485 patients who underwent successful SVR. Baseline PNI score was calculated before SVR on admission. The patients were divided into high and low PNI groups according to the cut-off value of PNI using the receiver operating characteristic (ROC) curve. Primary outcomes were composite adverse events, defined as worsening heart failure, myocardial infarction, major bleeding, uncontrolled infection, second surgery, post-operative arrhythmia or all-cause death during the follow-up. The association of PNI score and primary outcomes was presented as hazard ratios (HR) with 95% confidence intervals (CI) calculated by adverse events in the crude and multivariate-adjusted Cox Proportional Hazards models.Results Overall, adverse events were observed in 61(13%) patients. ROC curves revealed an area under curve of 0.676 for PNI with a cut-off of 46. The cumulative event rate by Kaplan–Meier analysis was higher in low PNI group (P < 0.001). Adjusted multivariate analysis showed that low PNI was associated with adverse outcomes (HR: 2.303, 95% CI: 1.338-3.964, P = 0.003). Conclusion Low PNI on admission in patients with SVR was associated with higher incidence of clinical adverse events. Using the PNI score to identify individuals with poor nutritional status might be an important method for clinical prognosis prediction, and improving nutritional status during follow-up might help to reduce the risks of adverse outcomes in these patients.

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“…2,4 In Canada, there are safety concerns related to hydroxyethyl starches that have limited the availability of synthetic colloids, 5 rendering albumin, a blood product purified from pooled human plasma, the most widely available colloid. 5,6 Albumin is distributed by the Canadian Blood Services (CBS) and He ´ma-Que ´bec. However, CBS does not currently include cardiac surgery as a recognized indication for albumin use because of the lack of highquality evidence showing benefit over crystalloids.…”

Section: Abstract Albumin á Colloids á Cardiac Surgery á Transfusionmentioning

confidence: 99%

“…However, CBS does not currently include cardiac surgery as a recognized indication for albumin use because of the lack of highquality evidence showing benefit over crystalloids. 6,7 Nevertheless, albumin remains available for use by clinicians at their discretion for this indication and is frequently administered in the routine perioperative care of cardiac surgical patients, either as part of the pump prime or for volume resuscitation. 5,6 Few studies have investigated current practices and conditions for perioperative albumin use in Canada; however, preliminary data suggest substantial variability exists across Canadian institutions and individual providers.…”

Section: Abstract Albumin á Colloids á Cardiac Surgery á Transfusionmentioning

confidence: 99%

L’albumine pour la réanimation liquidienne chez les patients de chirurgie cardiaque : sondage auprès des fournisseurs canadiens de soins périopératoires

Liu

McCluskey

Law

et al. 2022

Can J Anesth/J Can Anesth

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Purpose To evaluate the perceptions and practices of Canadian cardiovascular anesthesiologists and intensivists towards intravenous albumin as a resuscitation fluid in patients undergoing cardiac surgery. Methods We conducted a cross-sectional survey of cardiac anesthesiologists and intensivists involved in the care of cardiac surgical patients. The 22-item survey included seven open-ended questions and assessed practice patterns and attitudes towards albumin. Descriptive statistics were analyzed using counts and proportions. Qualitative data were analyzed to identify themes describing albumin use patterns in Canada. Results A total of 133 respondents from seven provinces participated, with 83 (62%) using albumin perioperatively. The majority of respondents (77%) felt a low fluid balance in cardiac surgical patients was important, and that supplementing crystalloids with albumin was helpful for

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L’albumine en chirurgie cardiaque adulte : un compte rendu narratif

Cited by 18 publications

References 126 publications

Priming of Cardiopulmonary Bypass with Human Albumin Decreases Endothelial Dysfunction after Pulmonary Ischemia–Reperfusion in an Animal Model

Priming of Cardiopulmonary Bypass with Human Albumin Decreases Endothelial Dysfunction after Pulmonary Ischemia–Reperfusion in an Animal Model

Low Prognostic Nutritional Index Contributes to High Risk of Adverse Events in Patients Undergoing Surgical Valve Replacement

L’albumine pour la réanimation liquidienne chez les patients de chirurgie cardiaque : sondage auprès des fournisseurs canadiens de soins périopératoires

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