Comparison of Albumin with Alternative Fluids

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Questions and Answers

What is the outcome of albumin infusion on the most compromised subjects with sepsis?

No influence on the outcome

Proven to worsen the outcome

Not enough evidence to conclude (correct)

Proven to improve the outcome

What is the effect of moderate albumin use on survival rate?

Improves survival rate with no harm-to-benefit ratio

Worsens survival rate with a strong harm-to-benefit ratio

Improves survival rate with a strong harm-to-benefit ratio (correct)

Improves survival rate with a weak harm-to-benefit ratio

In which condition has albumin been shown to improve organ dysfunctions?

Sepsis, severe acute pancreatitis, and decompensated cirrhosis (correct)

Sepsis and cirrhosis

Hepatic surgery and spontaneous bacterial peritonitis

Acute pancreatitis and burns

What is the maximum percentage of a patient's total circulating blood volume that can be replaced with edible purified bovine hemoglobin derivatives?

40% Signup and view all the answers

What is the acceptable cutoff for plasma-albumin administration in clinical practice according to the authors?

2.5 g/dL Signup and view all the answers

What is the characteristic of crystalloids in comparison to colloids?

Non-colligative and inexpensive Signup and view all the answers

What was the finding of the COSMOS Study regarding Human Albumin solution and crystalloids?

Human Albumin solution was similar to crystalloids in reducing postoperative complications Signup and view all the answers

What is the advantage of crystalloids over colloids?

Crystalloids are safer and less expensive Signup and view all the answers

What is a major limitation of synthetic colloids compared to human albumin?

Lack of oxygen-carrying capacity Signup and view all the answers

Why are synthetic colloids used in place of human albumin?

Due to their lower cost Signup and view all the answers

What is a unique property of human albumin that makes it suited for certain applications?

Its ability to exert intra- and extracellular effects Signup and view all the answers

What is a drawback of using synthetic colloids in high doses and concentrations?

Increased mortality in critically ill patients Signup and view all the answers

What is a key difference between synthetic colloids and human albumin?

Synthetic colloids are natural plasma constituents Signup and view all the answers

In which patients is human albumin particularly effective?

Patients with hypoalbuminemia Signup and view all the answers

What is the purpose of modifying natural polymers or polymerizing monomers to produce synthetic colloids?

To produce a polymeric chain with sufficient dimensions to exert the desired plasma-expanding effect Signup and view all the answers

Why are synthetic colloids not used during therapeutic plasma exchange?

Due to their molecular diameter exceeding the cut-off of the hollow fiber filter Signup and view all the answers

What is a characteristic of colloid solutions that makes them superior to crystalloids?

Their ability to offer a more lasting intravascular volume expansion Signup and view all the answers

What has been shown to be clinically effective in increasing both colloidal and total oncotic pressure?

The administration of human albumin Signup and view all the answers

Study Notes

Albumin as a Therapeutic Option

Albumin is associated with improved microcirculation perfusion and oxygen tissue supply in hypovolemic subjects.
Albumin infusion may influence the outcome of sepsis patients, but this is not proven.
Moderate use of albumin has been shown to improve survival rate with a strong harm-to-benefit ratio.

Albumin vs. Alternative Fluids

Albumin has been shown to improve organ dysfunctions in various conditions, including sepsis, severe acute pancreatitis, therapeutic plasma exchange, hepatic surgery, spontaneous bacterial peritonitis, burns, and decompensated cirrhosis.

Comparison with Crystalloids

Crystalloids are not colligative, readily available, inexpensive, and safer than colloids.
Crystalloids were found to be similar to Human Albumin solution in reducing postoperative complications in the COSMOS study.
Synthetic colloids are not 100% pure like Human Albumin solution and have been part of multiple controversies.

Colloid Solutions

Colloid solutions display distinct advantages, including long-term circulatory effects and impermeability in the vasculature.
Colloid molecules can exert intra- and extracellular effects, making them suitable for volume expansion with intrinsic anti-edema activity.

Human Albumin vs. Crystalloids

Human albumin may not be superior to crystalloids, but it has unique properties that make it suitable for certain applications, such as liver and renal failure, hypoalbuminemia, burn patients, critically ill, sepsis, and trauma.
Human albumin administration can increase both colloidal and total oncotic pressure.

Synthetic Colloids vs. Human Albumin

Synthetic colloids have no oxygen-carrying capacity and cannot be considered erythrocyte substitutes.
Synthetic colloid administration in high doses and concentrations has been associated with increased mortality in critically ill patients.
Synthetic colloids cannot be used during therapeutic plasma exchange or plasmapheresis due to their high molecular weight.

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Description

This quiz compares the efficacy of albumin with other fluids in hypovolemic subjects, discussing its effects on microcirculation and oxygen tissue supply. It also examines the outcomes of albumin infusion in sepsis patients and the moderate use of colloid compounds.