RETRACTED: Is Albumin Administration in Hypoalbuminemic Elderly Cardiac Surgery Patients of Benefit with Regard to Inflammation, Endothelial Activation, and Long-Term Kidney Function? (Retracted Article)

被引:42
作者
Boldt, Joachim [1 ]
Brosch, Ch. [1 ]
Roehm, K. [1 ]
Lehmann, A. [1 ]
Mengistu, A. [1 ]
Suttner, S. [1 ]
机构
[1] Klinikum Stadt Ludwigshafen, Dept Anesthesiol & Intens Care Med, D-67063 Ludwigshafen, Germany
关键词
D O I
10.1213/ane.0b013e31818370b2
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
BACKGROUND: Because patients with low albumin levels may benefit from human albumin (HA) administration, we studied correction of hypovolemia with HA in hypoalbuminic elderly cardiac surgery patients. METHODS: In a prospective, randomized study, 50 patients aged >80 yr undergoing cardiac surgery using cardiopulmonary bypass with a preoperative serum albumin concentration of <3.5 mg/dL, received either 5% HA (n = 25) or hydroxyethyl starch (6% HES 130/0.4) (n = 25). Volume was added to the priming (500 mL and given until the morning of the second postoperative day to keep pulmonary capillary wedge pressure or central venous pressure between 12 and 14 mm Hg. RESULTS: Inflammatory response (interleukins-6, -10), endothelial activation (intercellular adhesion molecule-1), and kidney function (including glutathione transferase-a and neutrophil gelatinase-associated lipocalin) were measured after induction of anesthesia, 5 h after surgery, and the first and second postoperative day. A follow-up, approximately 60 days after discharge from the hospital, was done. Two thousand nine hundred eighty +/- 430 mL of HA and 3060 +/- 680 mL of HES 130/0.4 were given. Serum albumin concentration was significantly increased by HA (to 4.5 +/- 0.3 mg/dL). Serum creatinine, glomerular filtration rate, and urinary levels of a-glutathione transferase and neutrophil gelatinase-associated lipocalin were not different in the HA-compared to the HES-treated patients. The inflammatory response was similar in both groups, whereas endothelial activation was less in the HES group. None of the patients developed renal failure requiring renal replacement therapy. CONCLUSION: Use of HA in hypoalbuminemic cardiac surgery patients aged >80 yr was without benefit with regard to inflammatory response, endothelial activation, and renal function compared to 6% HES 130/0.4.
引用
收藏
页码:1496 / 1503
页数:8
相关论文
共 31 条
[1]   Crystalloid-colloid controversy revisited [J].
Astiz, ME ;
Rackow, EC .
CRITICAL CARE MEDICINE, 1999, 27 (01) :34-35
[2]   Hetastarch and bleeding complications after coronary artery surgery [J].
Avorn, J ;
Patel, M ;
Levin, R ;
Winkelmayer, WC .
CHEST, 2003, 124 (04) :1437-1442
[3]   Intensive insulin therapy and pentastarch resuscitation in severe sepsis [J].
Brunkhorst, Frank M. ;
Engel, Christoph ;
Bloos, Frank ;
Meier-Hellmann, Andreas ;
Ragaller, Max ;
Weiler, Norbert ;
Moerer, Onnen ;
Gruendling, Matthias ;
Oppert, Michael ;
Grond, Stefan ;
Olthoff, Derk ;
Jaschinski, Ulrich ;
John, Stefan ;
Rossaint, Rolf ;
Welte, Tobias ;
Schaefer, Martin ;
Kern, Peter ;
Kuhnt, Evelyn ;
Kiehntopf, Michael ;
Hartog, Christiane ;
Natanson, Charles ;
Loeffler, Markus ;
Reinhart, Konrad .
NEW ENGLAND JOURNAL OF MEDICINE, 2008, 358 (02) :125-139
[4]   ROLE OF CYTOKINES IN THE PATHOGENESIS OF CARDIOPULMONARY-INDUCED MULTISYSTEM ORGAN FAILURE [J].
CASEY, LC .
ANNALS OF THORACIC SURGERY, 1993, 56 (05) :S92-S96
[5]   Effect of hydroxyethylstarch in brain-dead kidney donors on renal function in kidney-transplant recipients [J].
Cittanova, ML ;
Leblanc, I ;
Legendre, C ;
Mouquet, C ;
Riou, B ;
Coriat, P .
LANCET, 1996, 348 (9042) :1620-1622
[6]   PREDICTION OF CREATININE CLEARANCE FROM SERUM CREATININE [J].
COCKCROFT, DW ;
GAULT, MH .
NEPHRON, 1976, 16 (01) :31-41
[7]   Renal impact of fluid management with colloids: a comparative review [J].
Davidson, I. J. .
EUROPEAN JOURNAL OF ANAESTHESIOLOGY, 2006, 23 (09) :721-738
[8]   Effect of hydroxyethyl starch on vascular leak syndrome and neutrophil accumulation during hypoxia [J].
Dieterich, Hans-J rgen ;
Weissmueller, Thomas ;
Rosenberger, Peter ;
Eltzschig, Holger K. .
CRITICAL CARE MEDICINE, 2006, 34 (06) :1775-1782
[9]   Hydroxyethyl starch, but not modified fluid gelatin, affects inflammatory response in a rat model of polymicrobial sepsis with capillary leakage [J].
Feng, Xiaomei ;
Liu, Jian ;
Yu, Min ;
Zhu, Sihai ;
Xu, Jianguo .
ANESTHESIA AND ANALGESIA, 2007, 104 (03) :624-630
[10]  
Finfer S, 2004, NEW ENGL J MED, V350, P2247