Effects of concentrated albumin treatment after aortocoronary bypass surgery

Karanko, Meri S.; Laaksonen, V.; Meretoja, O. A.

doi:10.1097/00003246-198708000-00005

Cited by 21 publications

(7 citation statements)

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“…Studies that agree best with our current result include a mass balance study showing a T 1/2 corresponding to 17 h during major surgery [ 24 ] and a T 1/2 of 16 h as derived by radioisotopes corrected for plasma dilution after coronary bypass surgery [ 18 ].…”

Section: Discussionsupporting

confidence: 84%

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Plasma disappearance rate of albumin when infused as a 20% solution

et al. 2022

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Background The transcapillary leakage of albumin is increased by inflammation and major surgery, but whether exogenous albumin also disappears faster is unclear. Methods An intravenous infusion of 3 mL/kg of 20% albumin was given over 30 min to 70 subjects consisting of 15 healthy volunteers, 15 post-burn patients, 15 patients who underwent surgery with minor bleeding, 10 who underwent surgery with major bleeding (mean, 1.1 L) and 15 postoperative patients. Blood Hb and plasma albumin were measured on 15 occasions over 5 h. The rate of albumin disappearance from the plasma was quantitated with population kinetic methodology and reported as the half-life (T1/2). Results No differences were observed for T1/2 between volunteers, post-burn patients, patients who underwent surgery with minor bleeding and postoperative patients. The T1/2 averaged 16.2 h, which corresponds to 3.8% of the amount infused per h. Two groups showed plasma concentrations of C-reactive protein of approximately 60 mg/L and still had a similarly long T1/2 for albumin. By contrast, patients undergoing surgery associated with major hemorrhage had a shorter T1/2, corresponding to 15% of the infused albumin per h. In addition, our analyses show that the T1/2 differ greatly depending on whether the calculations consider plasma volume changes and blood losses. Conclusion The disappearance rate of the albumin in 20% preparations was low in volunteers, in patients with moderately severe inflammation, and in postoperative patients.

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Section: Discussionsupporting

confidence: 84%

“…The fluid content of the 20% albumin preparation is only 5 mL per gram albumin, which means that an infusion recruits fluid from extravascular sources to the plasma. The maximum plasma volume expansion is approximately twice the infused volume [ 9 – 12 , 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Plasma disappearance rate of albumin when infused as a 20% solution

et al. 2022

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“…However, the maximal effect of hypertonic saline on plasma volume seems not to be dependent on patient's volume status, since the effect was similar in hypovolaemic coronary artery bypass grafting patients and euvolaemic healthy volunteers. After coronary artery bypass grafting, patients have 5.5–7.5% reductions in plasma volume [19] whereas our volunteers were allowed to eat and drink normally before the study.…”

Section: Discussionmentioning

confidence: 99%

Effects of hypertonic saline (7.5%) on extracellular fluid volumes in healthy volunteers

Järvelä¹,

Koskinen²,

Kööbi³

2003

Anaesthesia

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SummaryWe developed a screening questionnaire to be used by nurses to decide which patients should see an anaesthetist for further evaluation before the day of surgery. Our objective was to measure the accuracy of responses to the questionnaire. Agreement between questionnaire responses and the anaesthetist's assessment was assessed. For questions with a prevalence of 5 to 95%, the Kappa coefficient was used; percentage agreement was used for all other questions. Criterion validity was excellent ⁄ good for all questions with a prevalence between 5 and 95%, except for the question 'Do you have kidney disease?' For questions with prevalence < 5%, all demonstrated adequate criterion validity except the questions 'Has anyone in your family had a problem following an anaesthetic?' and 'If you have been put to sleep for an operation were there any anaesthetic problems?' Therefore, it is reasonable for nurses to use this questionnaire to determine which patients an anaesthetist should see before the day of surgery.Keywords Anaesthesia; pre-operative, assessment, questionnaire. Recent advances in anaesthetic and surgical practice have facilitated the growth of 'fast track' surgery [1, 2]. Careful outpatient assessment is fundamental to the success of this type of surgery and the Association of Anaesthetists of Great Britain and Ireland now recommends assessment at a pre-operative assessment (POA) clinic [3].The provision of a pre-operative screening and assessment service at POA clinics supplies background information about patient's general medical status and fitness for anaesthesia. POA clinics improve patient care by allowing careful pre-operative evaluation and optimisation of coexisting disease [4], reduce costs [5, 6], improve efficiency [7], and lower surgical cancellation rates [8, 9].In POA clinics, nurses increasingly carry out preoperative screening [10]. Although they are not qualified to decide if a patient is fit for anaesthesia, they play a valuable role in identifying patients who are at risk and require further evaluation and optimisation before the day of surgery [11]. Nurses screen patients for risk factors for fitness for anaesthesia and surgery using questionnaires [12]. These can be self-administered by the patient [9], or used during structured interviews [13], or computer programs [14]. Although many locally developed questionnaires exist, few have been formally assessed.We have developed a multi-tiered screening questionnaire to be used by nurses to decide which patients should be seen at a POA clinic by an anaesthetist for further evaluation and optimisation. Using Delphi consensus methods, we have already evaluated content validity for each question [15] to ensure that the questions are relevant to concept being measured.Our objective was to perform item analysis of the screening questionnaire and measure criterion validity [16], that is, is it a true measure of what it is designed to measure?By testing individual questions beyond basic content validity, we were able to put them together in a...

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“…Hypothermia is generally used and this causes vasoconstriction, which may mask the changes in blood volume [6]. Reductions of 5.5–7.5% in blood volume have been observed after open heart surgery [8]. Rewarming after the operation causes vasodilation, which often results in lowering of arterial pressure.…”

Section: Introductionmentioning

confidence: 99%