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Benefits in heart surgery
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Albumin has beneficial effects during cardiopulmonary bypass surgery (CPB)
In cardiac surgery with CPB, haemodilution with reduced albumin concentration and decreased colloid oncotic pressure (COP) are the main factors associated with the myocardium, lungs, intestine and brain. The use of albumin can attenuate this deleterious effect and offer additional benefits.
As a priming solution, the use of albumin has been associate
Better preservation
platelet count2, 3, 4
and colloid osmotic pressure.3,4
Reduced need for blood transfusions and less blood loss in the post-operative period.2,4
Significantly fewer cases of post-operative bleeding that required re-operation to review haemostasis
(p = 0.033).2,4
Shorter duration of mechanical ventilation
in neonates receiving 5% albumin in priming and maintaining a COP of 18 mmHg compared to a lower target COP.1
References
1. Golab HD, Scohy TV, de Jong PL, Kissler J, Takkenberg JJ, Bogers AJ. Relevance of colloid oncotic pressure regulation during neonatal and infant cardiopulmonary bypass: a prospective randomized study. Eur J Cardiothorac Surg. 2011 Jun;39(6):886-91. doi: 10.1016/j.ejcts.2010.09.040. Epub 2010 Nov 5. PMID: 21055963. [PubMed]
2. Onorati F, Santarpino G, Renzulli A, De Feo M, De Santo LS, Della Corte A, Galdieri N, Cotrufo M. Does priming implementation with low-dose albumin reduce postoperative bleeding following cardiopulmonary bypass? Int J Artif Organs. 2003 Mar;26(3):211-6. doi: 10.1177/039139880302600306. PMID: 12703887. [PubMed]
3. Russell JA, Navickis RJ, Wilkes MM. Albumin versus crystalloid for pump priming in cardiac surgery: meta-analysis of controlled trials. J Cardiothorac Vasc Anesth. 2004 Aug;18(4):429-37. doi: 10.1053/j.jvca.2004.05.019. PMID: 15365922. [PubMed]
4. Moret E, Jacob MW, Ranucci M, Schramko AA. Albumin-Beyond Fluid Replacement in Cardiopulmonary Bypass Surgery: Why, How, and When? Semin Cardiothorac Vasc Anesth. 2014 Sep;18(3):252-9. doi: 10.1177/1089253214535667. Epub 2014 May 26. PMID: 24862323. [PubMed]
