Expert consensus on the use of human serum albumin in adult cardiac surgery

Fei, Xiang; Huang, Fuhua; Huang, Jiapeng; Li, Xin; Dong, Nianguo; Xiao, Yingbin; Zhao, Qiang; Xiao, Liwei; Zhang, Haitao; Zhang, Cui; Cheng, Zhaoyun; Chen, Jimei; Wang, Huishan; Guo, Yingqiang; Liu, Nan; Luo, Zhe; Hou, Xiaotong; Ji, Bingyang; Zhao, Ruiyang; Jin, Zhenxiao; Savage, Robert M.; Zhao, Yang; Zheng, Zhe; Chen, Xin

doi:10.1097/cm9.0000000000002709

Cited by 5 publications

(2 citation statements)

References 86 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 18 , 19 In cardiac surgery, hypoalbuminemia is frequently observed due to surgical loss and significant hemodilution. 20 Within our study cohort, 55.45% of patients exhibited albumin concentrations below 40 g/L. Notably, in a prior investigation focusing on off-pump CABG, a preoperative albumin level <40 g/L was independently associated with acute kidney injury.…”

Section: Discussionmentioning

confidence: 59%

Risk Factors and Short-Term Outcomes of Postoperative Pulmonary Complications in Elderly Patients After Cardiopulmonary Bypass

Liu,

Li,

Xie

et al. 2024

CIA

View full text Add to dashboard Cite

Objective The risk factors of postoperative pulmonary complications (PPCs) have been extensively investigated in non-cardiac surgery and non-elderly adult patients undergoing cardiac surgery. However, data on elderly patients after cardiopulmonary bypass (CPB) is limited. This study aimed to evaluate the risk factors and short-term outcomes for PPCs in elderly patients undergoing CPB procedures. Patients and Methods Data from 660 patients who underwent CPB over a six-year period at a tertiary care hospital were collected. The primary outcome encompassed the incidence of PPCs, including re-intubation, postoperative mechanical ventilation exceeding 48 hours, pulmonary infection, pleural effusion requiring thoracic drainage, and acute respiratory distress syndrome. Missing data were managed using multiple imputation. Univariate analysis and the multiple logistic regression method were utilized to ascertain independent risk factors for PPCs. Results Among the 660 patients, PPCs were observed in 375 individuals (56.82%). Multiple logistic regression identified serum albumin levels <40 g/L, type of surgery, CPB duration >150 minutes, blood transfusion, and intra-aortic balloon pump use before extubation as independent risk factors for PPCs. Patients experiencing PPCs had prolonged mechanical ventilation, extended hospitalization and ICU stays, elevated postoperative mortality, and higher tracheotomy rates compared to those without PPCs. Conclusion Elderly patients following CPB displayed a substantially high incidence of PPCs, significantly impacting their prognosis. Additionally, this study identified five prominent risk factors associated with PPCs in this population. These findings enable clinicians to better recognize patients who may benefit from perioperative prevention strategies based on these risk factors.

show abstract

Section: Discussionmentioning

confidence: 59%

Risk Factors and Short-Term Outcomes of Postoperative Pulmonary Complications in Elderly Patients After Cardiopulmonary Bypass

Liu,

Li,

Xie

et al. 2024

CIA

View full text Add to dashboard Cite

show abstract

“…Russell et al [99] demonstrated in their meta-analysis that using albumins in the priming solution improves the fluid balance and augments platelet preservation during the CPB. The same conclusion was reached by the expert consensus of Xiang et al [101] One of the major issues with albumin usage is its high cost, and there are no randomized controlled trials demonstrating albumin's superiority regarding postoperative outcomes such as mortality, ICU stay time, or organ dysfunction. All in all, albumin addition to the priming solution appears to be a promising perspective, but further scientific evidence is needed to confirm its suitability.…”

Section: Fluid Balance and Osmotic Regulationmentioning

confidence: 64%

Alterations to Kidney Physiology during Cardiopulmonary Bypass—A Narrative Review of the Literature and Practical Remarks

Udzik,

Pacholewicz,

Biskupski

et al. 2023

JCM

View full text Add to dashboard Cite

Introduction: According to different authors, cardiac surgery-associated acute kidney injury (CSA-AKI) incidence can be as high as 20–50%. This complication increases postoperative morbidity and mortality and impairs long-term kidney function in some patients. This review aims to summarize current knowledge regarding alterations to renal physiology during cardiopulmonary bypass (CPB) and to discuss possible nephroprotective strategies for cardiac surgeries. Relevant sections: Systemic and renal circulation, Vasoactive drugs, Fluid balance and Osmotic regulation and Inflammatory response. Conclusions: Considering the available scientific evidence, it is concluded that adequate kidney perfusion and fluid balance are the most critical factors determining postoperative kidney function. By adequate perfusion, one should understand perfusion with proper oxygen delivery and sufficient perfusion pressure. Maintaining the fluid balance is imperative for a normal kidney filtration process, which is essential for preserving the intra- and postoperative kidney function. Future directions: The review of the available literature regarding kidney function during cardiac surgery revealed a need for a more holistic approach to this subject.

show abstract

Intraoperative Colloid Use on Post-operative Renal Function

Chen,

Ma,

Peng

et al. 2024

Curr Anesthesiol Rep

View full text Add to dashboard Cite

Purpose of Review This review summarizes the most recent literature on the association between intraoperative colloid administration and its effect on post-operative renal function. Recent Findings It appears albumin decreases the incidence of acute kidney injury (AKI); however, meta-analysis studies show an increased need for post-operative renal replacement therapy. There was moderate certainty that early starches increased the need for renal replacement therapy; however, it appears newer starches have a better safety profile. Gelatins do not appear to contribute to renal dysfunction, despite a study showing a statistically insignificant higher incidence of moderate AKI. Studies involving dextran suggest better renal outcomes when used as a priming solution for cardiopulmonary bypass. Summary Albumin administration remains controversial with conflicting studies. While earlier starch products have been associated with renal dysfunction, further studies should be done on newer starches. There are limited studies for gelatins and dextran, suggesting possible renal-sparing effects.

show abstract

Expert consensus on the use of human serum albumin in adult cardiac surgery

Cited by 5 publications

References 86 publications

Risk Factors and Short-Term Outcomes of Postoperative Pulmonary Complications in Elderly Patients After Cardiopulmonary Bypass

Risk Factors and Short-Term Outcomes of Postoperative Pulmonary Complications in Elderly Patients After Cardiopulmonary Bypass

Alterations to Kidney Physiology during Cardiopulmonary Bypass—A Narrative Review of the Literature and Practical Remarks

Intraoperative Colloid Use on Post-operative Renal Function

Contact Info

Product

Resources

About