| Twenty-five percent albumin prevents lung injury following shock/resuscitation. | |
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MedLine Citation:
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PMID: 14501967 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate novel indications for the use of human albumin solutions in the prevention and treatment of acute lung injury following shock/resuscitation and to test the hypothesis that 25% human albumin is an effective resuscitation fluid as well as an immunomodulatory agent protective against lung injury in our model. DESIGN: A previously developed rodent model of acute lung injury in which resuscitated shock primes for increased lung injury in response to a small dose of intratracheal lipopolysaccharide. SETTING: University-affiliated hospital. SUBJECTS: Sprague Dawley rats weighing 300-350 g. INTERVENTIONS: Animals were bled to a mean arterial pressure of 40 mm Hg and maintained in a shock phase for 1 hr. Animals then were resuscitated by transfusion of the shed blood plus an equal volume of Ringer's lactate or their shed blood plus 3 mL/kg volume of 25% albumin or their shed blood plus 15 mL/kg of 5% human albumin over a period of 2 hrs. To test for the possible role of 25% albumin as an antioxidant, we also performed resuscitation with Ringer's lactate supplemented with N-acetylcysteine or 25% albumin depleted of its antioxidant properties by N-ethylmaleimide. Mean arterial pressure was monitored continuously. One hour after resuscitation, 100 microg of lipopolysaccharide in 200 microL of saline was administered intratracheally. MEASUREMENTS AND MAIN RESULTS: Resuscitation with 25% albumin significantly reduced transpulmonary protein flux, bronchoalveolar lavage fluid neutrophil counts, and the degree of histopathological injury compared with resuscitation with Ringer's lactate or 5% albumin. To delineate the underlying mechanism of this beneficial effect, the production of cytokine-induced neutrophil chemoattractant as well as nuclear translocation of its critical transcription factor nuclear factor-kappaB was measured. Both cytokine-induced neutrophil chemoattractant messenger RNA concentrations and nuclear factor-kappaB translocation were diminished following 25% albumin resuscitation. Furthermore, 25% albumin significantly decreased lipid peroxidation in plasma as measured by 8-isoprostane concentrations. N-ethylmaleimide modified 25% albumin, possessing lesser antioxidant activity, exhibited an attenuated protection from lung injury. CONCLUSIONS: Resuscitation with 25% albumin attenuates lung injury in this rat model. The beneficial effect was due to reduced neutrophil sequestration. The antioxidant properties of the 25% albumin preparation appeared to be partially responsible for the effects observed. These studies suggest a novel role for 25% albumin as an anti-inflammatory agent in neutrophil-mediated diseases, such as acute respiratory distress syndrome. |
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Authors:
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Kinga A Powers; Andras Kapus; Rachel G Khadaroo; Ruijuan He; John C Marshall; Thomas F Lindsay; Ori D Rotstein |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Critical care medicine Volume: 31 ISSN: 0090-3493 ISO Abbreviation: Crit. Care Med. Publication Date: 2003 Sep |
Date Detail:
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Created Date: 2003-09-22 Completed Date: 2003-11-17 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 2355-63 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, University Health Network, Toronto, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Albumins
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pharmacology* Analysis of Variance Animals Base Sequence Blotting, Northern Bronchoalveolar Lavage Fluid / chemistry Disease Models, Animal Dose-Response Relationship, Drug Male Molecular Sequence Data Oxidative Stress Polymerase Chain Reaction Rats Rats, Sprague-Dawley Respiratory Distress Syndrome, Adult / mortality, prevention & control* Resuscitation / methods* Sensitivity and Specificity Shock, Hemorrhagic / mortality, therapy* |
| Chemical | |
Reg. No./Substance:
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0/Albumins |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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