Usage of 25% albumin solution in the intraoperative and early postoperative periods of liver transplantation from a cadaveric donor.

Введение. Терапевтическое использование раствора человеческого альбумина у пациентов в периоперационном периоде трансплантации печени (ТП) представляет интерес в контексте осложнений и исходов операции. Цель исследования: оценить влияние интраоперационной трансфузии 25% раствора человеческого альбумина на течение раннего послеоперационного периода при ортотопической ТП от посмертного донора. Материалы и методы. В исследование включены 47 пациентов, которым была выполнена трупная ТП. Были сформированы 2 группы: пациенты группы 1 (n = 21) получали трансфузию 25% раствора человеческого альбумина в конце операции ТП и через 24 ч после операции; пациенты группы 2 (n = 26) получали трансфузию 25% раствора человеческого альбумина в первые сутки послеоперационного периода. Осуществляли контроль лабораторных параметров крови пациента перед началом оперативного вмешательства, через 24 ч и через 48 ч после операции. Интраоперационно оценивали значения систолического (САД) и диастолического (ДАД) артериального давления, частоту сердечных сокращений (ЧСС), дозу вазопрессоров, объем инфузионно-трансфузионной терапии, кровопотерю и диурез. В послеоперационном периоде фиксировали возможные осложнения, проведенные сеансы заместительной почечной терапии (ЗПТ), а также количество дней в стационаре. Результаты. Оценка значений САД, ДАД и ЧСС в начале и конце операции показала достоверно лучшие показатели гемодинамики и снижение дозировок вазопрессорной поддержки в конце вмешательства в группе 1 по сравнению с группой 2 (p < 0,05). В послеоперационном периоде инфекционные осложнения зарегистрированы у одного пациента группы 1 и у трех пациентов группы 2. Проведение ЗПТ потребовалось двум пациентам из группы 2. Все пациенты обеих групп были выписаны из стационара, при этом число дней госпитализации в группе 2 было статистически значимо больше по сравнению с пациентами группы 1: 26,9 ± 3,9 против 17,2 ± 4,3 (p < 0,05). Заключение. Интраоперационная инфузия 25% раствора альбумина позволяет стабилизировать показатели гемодинамики в конце операции ТП, снизить потребность в кардиотонической поддержке и сократить время госпитализации у пациентов после ТП. Background. The therapeutic use of human albumin solution in patients in the perioperative period of liver transplantation (LT) is of interest in the context of complications and outcomes of surgery. Objectives: to assess the effect of intraoperative transfusion of 25% human albumin solution on the early postoperative period in orthotopic LT from a postmortem donor. Patients/Methods. The study included 47 patients who underwent cadaveric LT. Two groups were formed: patients in group 1 (n = 21) received transfusion of 25% human albumin solution at the end of LT and 24 hours after surgery; patients in group 2 (n = 26) received transfusion of 25% human albumin solution on the first day of the postoperative period. The laboratory parameters of the patient’s blood were monitored before surgery, 24 hours later, and 48 hours after surgery. Intraoperatively, the values of systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR), dose of vasopressors, volume of infusion- transfusion therapy, blood loss and diuresis were assessed. In the postoperative period, possible complications, renal replacement therapy (RRT) sessions performed, and the number of days in the hospital were recorded. Results. Assessment of SBP, DBP and HR values showed significantly better hemodynamic parameters and reduced dosages of vasopressor support at the end of surgery in group 1 compared to group 2 (p < 0.05). In the postoperative period, infectious complications were registered in one patient of group 1 and in three patients of group 2. Two patients from group 2 required RRT. All patients were discharged from the hospital, while the number of hospitalization days in group 2 was statistically significantly greater than in patients in group 1: 26.9 ± 3.9 versus 17.2 ± 4.3 (p < 0.05). Conclusions. Intraoperative infusion of 25% albumin solution allows stabilizing hemodynamic parameters at the end of LT surgery, reducing the need for cardiotonic support and shortening the hospitalization time in patients after LT.

Hyperoncotic Albumin Solution in Continuous Renal Replacement Therapy Patients

<b><i>Aim:</i></b> The aim of this study was to investigate the association of hyperoncotic (20%) human albumin solution (HAS) with outcomes among critically ill patients receiving continuous renal replacement therapy (RRT). <b><i>Methods:</i></b> Analysis of the Randomized Evaluation of Normal versus Augmented Level (RENAL) RRT trial data. <b><i>Results:</i></b> Of 1,508 patients, 771 (51%) received albumin. Of these, 345 (45%) received 4% HAS only, 155 (20%) received 20% HAS only, and 271 (35%) received both. Patients who received combined 4% and 20% HAS were more severely ill, received more days of RENAL trial therapy and required mechanical ventilation for longer. Mean daily fluid balance was −288 mL (−904 to 261) with 20% HAS only versus 245 mL (−248 to 1,050) with 4% HAS only (<i>p</i> &#x3c; 0.001). On Cox proportional hazards regression, 20% HAS exposure was not associated with greater 90-day mortality (odds ratio 1.12, 95% confidence interval [CI]: 0.77–1.62; <i>p</i> = 0.55) or longer recovery to RRT independence (sub-hazard ratio 1.04, 95% CI: 0.84–1.30; <i>p</i> = 0.70) compared to those who received 4% HAS only. <b><i>Conclusions:</i></b> RENAL trial patients commonly received albumin in varying concentrations. The administration of 20% HAS was associated with a more negative fluid balance but was not independently associated with increased mortality or RRT dependence when compared to 4% HAS only.

Albumin Acts as a Lubricant on the Surface of Hydrogel and Silicone Hydrogel Contact Lenses

Feeling comfortable is the greatest concern for contact lens wearers, and it has been suggested that in vivo comfort could be corresponded to the in vitro friction coefficient of contact lenses. How tear albumin could affect the friction coefficient of silicone hydrogel and hydrogel contact lenses was analyzed by sliding a lens against a quartz glass in normal and extremely high concentration of albumin solution. Albumin deposition testing and surface roughness analysis were also conducted. The results showed that the friction coefficient of tested contact lenses did not correspond to both the albumin deposition amount and surface roughness, but we proposed a model of how albumin might act as a lubricant on the surface of some hydrogel and silicone hydrogel contact lenses. In conclusion, albumin provided lubrication for silicone hydrogel contact lenses regardless of albumin concentrations, while albumin only acted as a lubricant for hydrogel contact under normal concentration.

Application of Newly Synthesized Sulfobetaine Based on Sweet Almond Oil in Bath Liquids for Sensitive Skin

Three formulations for bath liquids were developed, differing in the type of amphoteric surfactant applied. The formulations used Cocamidopropyl Betaine, Cocamidpropyl Hydroxide and newly synthesized sulfobetaine based on sweet almond oil (Oleicamidopropyl Sultaine). The molecular structure of the surfactant used in the manufactured formulations has a negatively charged sulfonate group and a positively charged quaternary nitrogen atom. Such molecular structures suggest that the functional properties of this substance are mild. Based on the research, it was found that the bath fluid containing the newly synthesized sulfobetaine based on sweet almond oil had the lowest zein number, the lowest pH increase of bovine albumin solution and the lowest ability to emulsify fatty dirt. This indicates a very low irritant effect of the tested bath liquid.

The Effect of pH and Concentration on the Textural and Rheological Properties of Egg Albumin Foams

The effect of different concentrations (i.e. 0.1% - 1%) and pH (7.0 and 4.0) on the textural/physical and rheological properties of egg albumin foams was investigated. The findings indicated that the stability and overrun of the foams were higher in the case of the foams made at pH = 4.0 and with the highest concentration of egg albumin (1%). The apparent viscosity of the albumin solution was significantly (p<0.05) higher at pH = 4.0 and in the presence of the higher concentrations of egg albumin (0.5% - 1%). All of the rheological parameters in amplitude sweep test indicated a weak structure of the foam made at pH = 7.0 and in the presence of a low concentration of egg albumin (0.1%). Regardless of the pH, the values for tan (δ) in the frequency sweep test indicated a weak biopolymer foam structure in the case of all samples. Yield stress was greater in the sample manufactured at pH = 4.0. Overall, the findings suggested that both protein concentration and pH had substantial effects on the rheological and physical properties of egg albumin foams.

Human albumin solutions in intensive care: A review

Albumin plays a key role in the critically ill patient acting as a prognostic marker and as a therapy in the form of human albumin solutions. However, the use of human albumin solution has varied over time with notable differences between health systems. Whilst its use is widely accepted for some clinical indications, its role has not always been clear in the critically ill and has been found to be harmful in some cohorts. Numerous studies have showed conflicting results and critical care clinicians have not always been guided by robust evidence. Nonetheless, at present the use of human albumin solution appears to be increasing again in the United Kingdom. Below, we discuss the latest evidence base for its use in critically ill patients.