Uses and misuses of albumin during resuscitation and in the neonatal intensive care unit

Shalish, Wissam; Olivier, François; Aly, Hany; Sant’Anna, Guilherme M.

doi:10.1016/j.siny.2017.07.009

Cited by 27 publications

(16 citation statements)

References 49 publications

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“…Premature birth can cause several problems in neonates, such as low birth weight and immature organs in the neonatal period. Along with birth weight, the serum albumin value of neonates is closely related to gestational week of delivery [16]. Emil S et al [17] mentioned that meconium ileus is more likely to occur in preterm infants than in full-term infants due to the low motility of the immature intestine.…”

Section: Discussionmentioning

confidence: 99%

Can early surgery improve the outcome of patients with meconium peritonitis? A single-center experience over 16 years

Jiang

Pan

et al. 2019

BMC Pediatr

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BackgroundIn the last century, meconium peritonitis(MP)was once a highly fatal gastrointestinal. disease With the development of fetal radiological technology, abnormal signs, such as pseudocysts, can. be detected during the fetal period so that more patients can be diagnosed prenatally and receive surgery. in the early stage of life. The survival rate of MP has increased up to 80% in recent years. According to. a review of the treatment and outcomes of patients diagnosed with MP, we evaluated the influence of. early operation on survival rate and discussed the risk factors of prognosis.MethodsWe collected 79 cases of patients diagnosed with MP who were treated in our department. from October 2001 to December 2017. They were divided into 2 groups. Patients in group A were born. in our hospital. Patients in group B were born in a local hospital with suspicion of MP and then transferred. to our department.ResultsThe birth weight (BW) and gestational age (GA) of patients were higher in group A than in. group B. There was no significant difference in the proportion of premature and low birth weight (LBW). patients between the two groups (p = 0.422, p = 0.970). Their age at the time of surgery was younger in. group A than in group B (1.4 ± 2.0 vs. 6.9 ± 14.9, p < 0.001). The overall survival rate of group A was higher. than that of group B (95.0% vs. 79.5%, p = 0.038). The prognosis of premature patients was worse than. that of full-term infants for both groups (p = 0.012).ConclusionsPrematurity is a significant risk factor related to death for MP patients. The survival rate. of MP patients can be improved by early operation during the neonatal period.

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Section: Discussionmentioning

confidence: 99%

Can early surgery improve the outcome of patients with meconium peritonitis? A single-center experience over 16 years

Jiang

Pan

et al. 2019

BMC Pediatr

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“…Hypoalbuminemia and hypotension during neonatal sepsis are frequently tackled with albumin infusion, in the attempt to raise intravascular oncotic pressure despite the absence of scientific evidence, or evidence-based therapeutic individualization (88). In few septic neonates, indeed, albumin may not elicit the desired effect but, instead, worsen the water shift toward the extravascular space (89). The role of endothelial glycocalyx in these cases has yet to be explored.…”

Section: Interplay Between Immune System and Endothelium During Neonamentioning

confidence: 99%

Vascular Endothelium in Neonatal Sepsis: Basic Mechanisms and Translational Opportunities

et al. 2019

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Neonatal sepsis remains a major health issue worldwide, especially for low-birth weight and premature infants, with a high risk of death and devastating sequelae. Apart from antibiotics and supportive care, there is an unmet need for adjunctive treatments to improve the outcomes of neonatal sepsis. Strong and long-standing research on adult patients has shown that vascular endothelium is a key player in the pathophysiology of sepsis and sepsis-associated organ failure, through a direct interaction with pathogens, leukocytes, platelets, and the effect of soluble circulating mediators, in part produced by endothelial cells themselves. Despite abundant evidence that the neonatal immune response to sepsis is distinct from that of adults, comparable knowledge on neonatal vascular endothelium is much more limited. Neonatal endothelial cells express lower amounts of adhesion molecules compared to adult ones, and present a reduced capacity to neutralize reactive oxygen species. Conversely, available evidence on biomarkers of endothelial damage in neonates is not as robust as in adult patients, and endothelium-targeted therapeutic opportunities for neonatal sepsis are almost unexplored. Here, we summarize current knowledge on the structure of neonatal vascular endothelium, its interactions with neonatal immune system and possible endothelium-targeted diagnostic and therapeutic tools for neonatal sepsis. Furthermore, we outline areas of basic and translational research worthy of further study, to shed light on the role of vascular endothelium in the context of neonatal sepsis.

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“…Therefore, it has been used as a volume expander since the 1940s (Garcia-Martinez et al 2013;Vincent et al 2014). However, over the past few decades, an increasing number of studies have demonstrated that HSA is a multifunctional protein (Fanali et al 2012;Shalish et al 2017;Setoyama et al 2017;Kawakami et al 2006) with roles in the binding and transport of endogenous and exogenous molecules (Sleep 2015), anti-oxidation and anti-inflammation, endothelial stabilisation, anti-thrombosis, and the adjustment of capillary permeability. It has been shown that albumin infusion can improve the prognosis of patients with spontaneous peritonitis (Sort et al 1999;Jamtgaard, Manning, and Cohn 2016) or hepatorenal syndrome (Ortega et al 2002;Martin-Llahi et al 2008), not only via plasma volume expansion, but also because of its non-colloid osmotic function.…”

Section: Introductionmentioning

confidence: 99%

Impaired albumin function: a novel potential indicator for liver function damage?

et al. 2019

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Albumin is the most abundant plasma protein and albumin infusion is commonly used. Conventionally, the biologic and therapeutic effects of albumin have been thought to be due to its oncotic properties. However, albumin has a variety of biologic functions, including molecular transport, anti-oxidation, anti-inflammation, endothelial stabilisation, anti-thrombotic effects, and the adjustment of capillary permeability. Despite this, the functions of albumin have not been thoroughly investigated. Recent studies have shown non-alcoholic fatty liver disease (NAFLD), viral hepatitis, cirrhosis, and liver failure to be associated with impairments in albumin function, which are associated with impairments in liver function and disease prognosis. Post-translational modifications of albumin cause structural modifications that affect protein function. Recently, the concentration of albumin associated with normal function, the 'efficient albumin concentration', has been attracting more interest. In addition, although many biologic markers, including albumin concentration, are widely used for the assessment of early liver dysfunction in patients with liver diseases, the predictive values are unsatisfactory. However, clinical evidence has suggested that albumin function may represent a novel biomarker of early impairment in liver function. In this review, we summarise the factors affecting albumin function and discuss the clinical significance of impairments in albumin function in various liver diseases. KEY MESSAGES1. The importance of albumin depends not only on its concentration, but also on its various physiological functions. 2. Impaired albumin function has been reported in a variety of liver diseases, and is associated with disease severity and prognosis, thereby proposing the concept of 'effective albumin concentration'. 3. Albumin dysfunction occurs earlier than other conventional indicators, and albumin dysfunction may be a new biomarker of early impairment in liver function. 4. Many exogenous and endogenous factors lead to post-translational modifications of albumin, which alters the three-dimensional structure of albumin, resulting in a decrease in its biological activity.

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Uses and misuses of albumin during resuscitation and in the neonatal intensive care unit

Cited by 27 publications

References 49 publications

Can early surgery improve the outcome of patients with meconium peritonitis? A single-center experience over 16 years

Can early surgery improve the outcome of patients with meconium peritonitis? A single-center experience over 16 years

Vascular Endothelium in Neonatal Sepsis: Basic Mechanisms and Translational Opportunities

Impaired albumin function: a novel potential indicator for liver function damage?

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