Non-oncotic properties of albumin. A multidisciplinary vision about the implications for critically ill patients.
Effective resuscitation with human albumin solutions is achieved with less fluid than with crystalloid solutions. However, the role of albumin in today's critical care unit is also linked to its multiple pharmacological effects. Areas covered: The potential clinical benefits of albumin in select populations of critically ill patients like sepsis seem related to immunomodulatory and anti-inflammatory effects, antibiotic transportation and endothelial stabilization. Albumin transports many drugs used in critically ill patients. Such binding to albumin is frequently lessened in critically ill patients with hypoalbuminemia. These changes could result in sub-optimal treatment. Albumin has immunomodulatory capacity by binding several bacterial products. Albumin also influences vascular integrity, contributing to the maintenance of the normal capillary permeability. Moreover, the albumin molecule encompasses several antioxidant properties, thereby significantly reducing re-oxygenation injury, which is especially important in sepsis. In fact, most studies of albumin administration are a combination of a degree of resuscitation with a degree of maintenance or supplementation of albumin. Expert commentary: The potential clinical benefits of the use of albumin in selected critically ill patients such as sepsis seem related to its immunomodulatory and anti-inflammatory effects, antioxidant properties, antibiotic transportation and endothelial stabilization. Additional studies are warranted to further elucidate the underlying physiologic and molecular rationale.
['Ferrer|Ricard|R|', 'Mateu|Xavier|X|', 'Maseda|Emilio|E|', 'Yébenes|Juan Carlos|JC|', 'Aldecoa|César|C|', 'De Haro|Candelaria|C|', 'Ruiz-Rodriguez|Juan Carlos|JC|', 'Garnacho-Montero|José|J|']
D000818:Animals D016638:Critical Illness D000077324:Crystalloid Solutions D006801:Humans D034141:Hypoalbuminemia D007362:Intensive Care Units D007552:Isotonic Solutions D012151:Resuscitation D018805:Sepsis D000075462:Serum Albumin, Human
Albumin critical care sepsis antioxidation drug transportation endothelium immunomodulation