Albumin bolus administration versus continuous infusion in critically ill hypoalbuminemic pediatric patients

Greissman, Allan; Silver, Peter; Nimkoff, Laura; Sagy, Mayer

doi:10.1007/bf01712175

Cited by 13 publications

(11 citation statements)

References 18 publications

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“…It remains unclear the reasons of the rapid decrease in plasma albumin concentration 48 h after administration since the reported life-time of monomeric albumin in humans is in the range of 28–36 days 38 . However, our finding is in line with that observed in analbuminemic patients and adult Gunn rats infused with HSA 33 39 40 , where plasma albumin levels increased immediately after infusion, but substantially decreased 24 h post-treatment. Moreover, it was shown that albumin half-life in mice infused with mouse albumin was 35 h 41 while that of mice infused with HSA was 21 h 42 .…”

Section: Discussionsupporting

confidence: 92%

Albumin administration prevents neurological damage and death in a mouse model of severe neonatal hyperbilirubinemia

Vodret

Bortolussi

Schreuder

et al. 2015

Sci Rep

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Therapies to prevent severe neonatal unconjugated hyperbilirubinemia and kernicterus are phototherapy and, in unresponsive cases, exchange transfusion, which has significant morbidity and mortality risks. Neurotoxicity is caused by the fraction of unconjugated bilirubin not bound to albumin (free bilirubin, Bf). Human serum albumin (HSA) administration was suggested to increase plasma bilirubin-binding capacity. However, its clinical use is infrequent due to difficulties to address its potential preventive and curative benefits, and to the absence of reliable markers to monitor bilirubin neurotoxicity risk. We used a genetic mouse model of unconjugated hyperbilirubinemia showing severe neurological impairment and neonatal lethality. We treated mutant pups with repeated HSA administration since birth, without phototherapy application. Daily intraperitoneal HSA administration completely rescued neurological damage and lethality, depending on dosage and administration frequency. Albumin infusion increased plasma bilirubin-binding capacity, mobilizing bilirubin from tissues to plasma. This resulted in reduced plasma Bf, forebrain and cerebellum bilirubin levels. We showed that, in our experimental model, Bf is the best marker to determine the risk of developing neurological damage. These results support the potential use of albumin administration in severe acute hyperbilirubinemia conditions to prevent or treat bilirubin neurotoxicity in situations in which exchange transfusion may be required.

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Section: Discussionsupporting

confidence: 92%

Albumin administration prevents neurological damage and death in a mouse model of severe neonatal hyperbilirubinemia

Vodret

Bortolussi

Schreuder

et al. 2015

Sci Rep

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“…First, STB is a chronic wasting disease with 25.7% of patients experiencing pulmonary tuberculosis as a complication. These patients have high nutritional requirements and lower protein intake, and the inflammation caused by the tuberculosis infection increases albumin consumption, which in turn leads to the half-life time of albumin being decreased to 8.2 ± 1.4 days, while the normal value is 12.5 ± 1.7 days [ 22 , 23 ]. Second, debridement surgery in patients with STB is a critical factor that can lead to low postoperative albumin levels.…”

Section: Discussionmentioning

confidence: 99%

Value of Postoperative Serum Albumin to Predict Postoperative Complication Severity in Spinal Tuberculosis

Jiang

Zhu

et al. 2022

BioMed Research International

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Background. Many complications occur after surgery in patients with spinal tuberculosis (STB); however, the severity varies in different patients. The complications’ severity is evaluated from grades I to V by the Clavien–Dindo classification (CDC), and grade V is the most severe. Most complications are mild, and only severe complications are life threatening, and thus, it is important to identify severe complications in patients with STB. The purpose of this study was to identify the risk factors of postoperative complication severity in patients with STB. Methods. Between January 2012 and May 2021, a retrospective study included 188 patients that underwent STB debridement surgery. The patients were divided into three groups based on postoperative complication severity. Clinical characteristics measured included age, sex, body mass index (BMI), comorbidities of diabetes mellitus and pulmonary tuberculosis, alcohol use and smoking history, course of disease, preoperative hemoglobin, preoperative serum albumin, preoperative lymphocytes, preoperative erythrocyte sedimentation rate (ESR), preoperative C-reactive protein (CRP), surgical approach, operating time, blood loss during surgery, postoperative hemoglobin, and postoperative serum albumin. The clinical characteristics of patients with STB who developed postoperative complications were evaluated using logistic regression analysis. Results. 188 patients suffered at least one postoperative complication; 77, 91, and 20 patients experienced grade I, II, and III-IV complications, respectively. In the univariate analysis, sex, diabetes mellitus, postoperative hemoglobin, and postoperative albumin are statistically significant. In the multivariable analysis, postoperative albumin (adjusted odds ratio OR = 0.861 , P < 0.001 ) was an independent risk factor of the postoperative complication severity in patients with STB. Receiver operating characteristic (ROC) analysis showed that the optimal cutoff values for postoperative albumin were 32 g/L (sensitivity: 0.571, specificity: 0.714, area under the ROC curve: 0.680) and 30 g/L (sensitivity: 0.649, specificity: 0.800, area under the ROC curve: 0.697) for grade II and grade III-IV complications, respectively. Conclusions. Postoperative albumin is an independent risk factor for postoperative complication severity in patients with STB. The improvement of postoperative albumin levels may reduce the risk of severe complications in patients with STB.

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“…Increase in serum albumin to levels above 2 g/dL might be associated with less edema. Intradialytic albumin infusions enabled removal of excess fluids in the first 2 weeks, but probably did not contribute to the increase in serum albumin level, as it was shown that albumin infusion during several hours even in catabolic patients without proteinuria had no significant effect on serum albumin level after 24 hr ( 29). Though normal serum albumin levels are difficult to achieve, there was a significant elevation to the level of 2 g/dL within two weeks after initiation of therapy, which could help in moderating edema.…”

Section: Discussionmentioning

confidence: 99%

Dialysis Rounds: Management of Hypoalbuminemia and Malnutrition in an End‐Stage Renal Disease Patient with Crohn's Disease and Amyloidosis

Tovbin

Markovitz

Landver

et al. 1999

Seminars in Dialysis

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Albumin bolus administration versus continuous infusion in critically ill hypoalbuminemic pediatric patients

Abstract: The half-life of exogenous albumin in the critically ill hypoalbuminemic pediatric patient is short if given as a bolus. Continuous infusion therapy appears to be more efficacious in increasing BAC over time, as the half-life with this method appears to be longer.

Cited by 13 publications

References 18 publications

Albumin administration prevents neurological damage and death in a mouse model of severe neonatal hyperbilirubinemia

Albumin administration prevents neurological damage and death in a mouse model of severe neonatal hyperbilirubinemia

Value of Postoperative Serum Albumin to Predict Postoperative Complication Severity in Spinal Tuberculosis

Dialysis Rounds: Management of Hypoalbuminemia and Malnutrition in an End‐Stage Renal Disease Patient with Crohn's Disease and Amyloidosis

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