Comparison Between Hyperoncotic and Isooncotic Albumin to Support Blood Loss Replacement

Summary

Fluid intravascular replacement is usually performed with either balanced crystalloids or iso-oncotic colloids, (synthetic colloids, plasma and 5% albumin). Doubts have been raised about synthetic colloids, and albumin solutions have been used more extensively. Albumin is the main protein responsible for plasma oncotic pressure and its volume expansion effect. The mobilization of extravascular fluid by infusing a hyper-oncotic solution like 20% albumin solution has been shown, causing endogenous fluid recruitment and blood volume expansion. The primary objective of this study is to compare the effect on plasma volume expansion and fluid recruitment of 3 different types of fluids (Albumin 5% and Albumin 20% and Ringer-lactate) during the hemorrhagic phase of the cystectomy procedure. Secondary objectives are the assessment of the hemodynamic parameters during surgery and the follow-up of pro-ANP and pro-BNP peptides. Glycocalyx proteins will be followed to evaluate endothelial wall shedding and microcirculation damages.

Timeline

Start

2022-05-25

Primary completion

2023-03-30

Completion

2023-04-10

Publications

• Jardot F, Hahn RG, Huber M, Wuethrich PY. Detection of hypovolemia by non-invasive hemodynamic monitoring during major surgery using Ringer s solution, 5% albumin, or 20% albumin as infusion fluid: a post-hoc analysis of a randomized clinical trial. Crit Care. 2025 Mar 23;29(1):132. doi: 10.1186/s13054-025-05357-z.
• Jardot F, Hahn RG, Engel D, Beilstein CM, Wuethrich PY. Blood volume and hemodynamics during treatment of major hemorrhage with Ringer solution, 5% albumin, and 20% albumin: a single-center randomized controlled trial. Crit Care. 2024 Feb 5;28(1):39. doi: 10.1186/s13054-024-04821-6.

Drugs

Indications

No indication recorded.