Serum albumin at admission for prediction of functional outcome in ischaemic stroke patients

Cho, Yoon-Mi; Choi, In-Sung; Bian, Ren-Xiu; Kim, Jae-Hyung; Han, Jae‐Young; Lee, Sam-Gyu

doi:10.1007/s10072-008-1024-0

Cited by 44 publications

(35 citation statements)

References 15 publications

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“…697 In experimental models of focal ischemia, albumin reduces ischemic brain swelling, improves regional cerebral blood flow, reduces postischemic thrombosis, improves microvascular flow, and supplies free fatty acids to the postischemic brain. 672,698,699 In several observational studies, 700,701 low serum albumin at admission correlated with higher rates of death and disability among patients with ischemic stroke. Subsequently, the ALIAS (Albumin in Acute Stroke) Pilot Clinical Trial evaluated 6 doses (0.34-2.05 g/kg) 702,703 of 2-hour infusion of 25% human albumin beginning within 16 hours of stroke onset in patients with acute ischemic stroke.…”

Section: Albumin For Treatment Of Acute Ischemic Strokementioning

confidence: 99%

Guidelines for the Early Management of Patients With Acute Ischemic Stroke

Jauch¹,

Saver²,

Adams³

et al. 2013

Stroke

5,293

1,801

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Background and Purpose-The authors present an overview of the current evidence and management recommendations for evaluation and treatment of adults with acute ischemic stroke. The intended audiences are prehospital care providers, physicians, allied health professionals, and hospital administrators responsible for the care of acute ischemic stroke patients within the first 48 hours from stroke onset. These guidelines supersede the prior 2007 guidelines and 2009 updates. Methods-Members of the writing committee were appointed by the American Stroke Association Stroke Council's Scientific Statement Oversight Committee, representing various areas of medical expertise. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Panel members were assigned topics relevant to their areas of expertise, reviewed the stroke literature with emphasis on publications since the prior guidelines, and drafted recommendations in accordance with the American Heart Association Stroke Council's Level of Evidence grading algorithm. Results-The goal of these guidelines is to limit the morbidity and mortality associated with stroke. The guidelines support the overarching concept of stroke systems of care and detail aspects of stroke care from patient recognition; emergency medical services activation, transport, and triage; through the initial hours in the emergency department and stroke unit. The guideline discusses early stroke evaluation and general medical care, as well as ischemic stroke, specific interventions such as reperfusion strategies, and general physiological optimization for cerebral resuscitation. The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest. Guidelines for the Early Management of PatientsThis statement was approved by the American Heart Association Science Advisory and Coordinating Committee on December 12, 2012. A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By Topic" link or the "By Publication Date" link. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@wolterskluwer.com.The Executive Summary is available as an online-only Data Supplement with this article at http://stroke.ahajournals.org/lookup/suppl/ doi:10.1161/STR.0b013e318284056a/-/DC1.The American Heart Association requests that this document be cited as follows: Jauch EC, Saver JL, Adams HP Jr, Bruno A, Connors JJ, Demaerschalk BM, Khatri P, McMullan PW Jr, Qureshi AI, Rosenfield K, Scott PA, Summers DR, Wang DZ, Wintermark M, Yonas H; on behalf of the American Heart Association Stroke Council, Council on Cardio...

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Section: Albumin For Treatment Of Acute Ischemic Strokementioning

confidence: 99%

Guidelines for the Early Management of Patients With Acute Ischemic Stroke

Jauch¹,

Saver²,

Adams³

et al. 2013

Stroke

5,293

1,801

View full text Add to dashboard Cite

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“…Several clinical studies have reported higher concentration of circulatory ALB at admission, which is predictive of a better functional outcome and lower mortality in ischemic stroke patients [59], [60]. However, unlike others, we have seen a complementary trend by focusing on patients with non-disabling lacunar stroke only.…”

Section: Discussionmentioning

confidence: 59%

Discovery of Prognostic Biomarker Candidates of Lacunar Infarction by Quantitative Proteomics of Microvesicles Enriched Plasma

2014

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BackgroundLacunar infarction (LACI) is a subtype of acute ischemic stroke affecting around 25% of all ischemic stroke cases. Despite having an excellent recovery during acute phase, certain LACI patients have poor mid- to long-term prognosis due to the recurrence of vascular events or a decline in cognitive functions. Hence, blood-based biomarkers could be complementary prognostic and research tools.Methods and FindingPlasma was collected from forty five patients following a non-disabling LACI along with seventeen matched control subjects. The LACI patients were monitored prospectively for up to five years for the occurrence of adverse outcomes and grouped accordingly (i.e., LACI-no adverse outcome, LACI-recurrent vascular event, and LACI-cognitive decline without any recurrence of vascular events). Microvesicles-enriched fractions isolated from the pooled plasma of four groups were profiled by an iTRAQ-guided discovery approach to quantify the differential proteome. The data have been deposited to the ProteomeXchange with identifier PXD000748. Bioinformatics analysis and data mining revealed up-regulation of brain-specific proteins including myelin basic protein, proteins of coagulation cascade (e.g., fibrinogen alpha chain, fibrinogen beta chain) and focal adhesion (e.g., integrin alpha-IIb, talin-1, and filamin-A) while albumin was down-regulated in both groups of patients with adverse outcome.ConclusionThis data set may offer important insight into the mechanisms of poor prognosis and provide candidate prognostic biomarkers for validation on larger cohort of individual LACI patients.

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“…Within this series most patients were incidentally identified and reported only minor symptoms, such as peripheral edema, related to low albumin. Nevertheless, an association between hypoalbuminemia and harmful effects or outcomes among normal subjects and/or the patients with non-neurological diagnoses is shown in Table 2 [12][13][14][15][16][17][18][19][20][21] and in Table 3 [22][23][24][25][26] for the patients with a neurological disease or injury. The strong association between hypoalbuminemia and morbidity/mortality as shown in Tables 2 and 3 is generally accepted.…”

Section: Is Hypoalbuminemia Harmful?mentioning

confidence: 96%

“…There is no stored reservoir of albumin, hence the serum concentration depends upon the balance between albumin synthesis in the liver, its metabolism and those forces shown in Table 1 that deplete it [6,7]. Important physiologic roles for serum albumin are summarized in Table 4 [3,6,7,13,22,24,[29][30][31], and illustrate its diverse functions within normal physiological homeostasis.…”

Section: Normal Functions Of Serum Albuminmentioning

confidence: 99%

In My Opinion: Serum Albumin Should be Maintained During Neurocritical Care

Powner¹

2011

Neurocrit Care

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Hypoalbuminemia is common among critically ill/injured patients and is strongly associated with increased morbidity and mortality in the patients with and without neurological conditions. Normal serum albumin is important as the primary intravascular antioxidant, in transporting a variety of hormones, medications and electrolytes, in providing colloid osmotic pressure during trans-compartmental fluid movement, in enhancing organ and tissue blood flow, and in supporting acid-base balance. Studies of albumin administration during intravascular resuscitation have not addressed potential longer term benefits to sustaining serum albumin concentrations during critical care. Evidence for such benefit is present although additional prospective studies are needed.

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Serum albumin at admission for prediction of functional outcome in ischaemic stroke patients

Cited by 44 publications

References 15 publications

Guidelines for the Early Management of Patients With Acute Ischemic Stroke

Guidelines for the Early Management of Patients With Acute Ischemic Stroke

Discovery of Prognostic Biomarker Candidates of Lacunar Infarction by Quantitative Proteomics of Microvesicles Enriched Plasma

In My Opinion: Serum Albumin Should be Maintained During Neurocritical Care

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