| A randomized unblinded pilot study comparing albumin versus hydroxyethyl starch in spontaneous bacterial peritonitis. | |
MedLine Citation:
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PMID: 16108036 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The administration of albumin improves circulatory function, prevents hepatorenal syndrome, and reduces hospital mortality in patients with cirrhosis and spontaneous bacterial peritonitis. This randomized unblinded pilot study compared the effect of albumin (10 patients) and the synthetic plasma expander hydroxyethyl starch 200/0.5 (10 patients) on the systemic hemodynamics of patients with spontaneous bacterial peritonitis. Baseline measurements were performed within 12 hours after diagnosis of infection. Patients then received 2 doses of the volume expander (1.5 g/kg body weight after baseline measurements and 1 g/kg body weight on day 3). Measurements were repeated after infection resolution. Treatment with albumin was associated with a significant increase in arterial pressure and a suppression of plasma renin activity, indicating an improvement in circulatory function. This occurred in the setting of a significant expansion of central blood volume (increase in cardiopulmonary pressures and atrial natriuretic factor) and an increase in systolic volume and systemic vascular resistance. In contrast, no significant changes were observed in these parameters in patients treated with hydroxyethyl starch. Von Willebrand-related antigen plasma levels significantly decreased in patients treated with albumin but not in those treated with hydroxyethyl starch. Serum nitrates and nitrites increased in patients treated with hydroxyethyl starch but not in those treated with albumin. These data suggest an effect of albumin on endothelial function. In conclusion, albumin but not hydroxyethyl starch improves systemic hemodynamics in patients with spontaneous bacterial peritonitis. This effect is due not only to volume expansion but also to an action on the peripheral arterial circulation. |
Authors:
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Javier Fernández; Joan Monteagudo; Xavier Bargallo; Wladimiro Jiménez; Jaume Bosch; Vicente Arroyo; Miguel Navasa |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Hepatology (Baltimore, Md.) Volume: 42 ISSN: 0270-9139 ISO Abbreviation: Hepatology Publication Date: 2005 Sep |
Date Detail:
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Created Date: 2005-08-29 Completed Date: 2005-09-22 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8302946 Medline TA: Hepatology Country: United States |
Other Details:
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Languages: eng Pagination: 627-34 Citation Subset: IM |
Affiliation:
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Liver Unit, IMDM and IDIBAPS, Hospital Clínic, University of Barcelona, Spain. Jfdez@clinic.ub.es |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Bacterial Agents
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therapeutic use Bacterial Infections / therapy* Ceftriaxone / therapeutic use Female Hemodynamics / drug effects, physiology Hetastarch / therapeutic use* Humans Kidney Function Tests Liver Function Tests Male Middle Aged Peritonitis / therapy* Pilot Projects Plasma Substitutes / therapeutic use* Serum Albumin / therapeutic use* von Willebrand Factor / metabolism |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 0/Plasma Substitutes; 0/Serum Albumin; 0/von Willebrand Factor; 73384-59-5/Ceftriaxone; 9005-27-0/Hetastarch |
| Comments/Corrections | |
Comment In:
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Hepatology. 2005 Sep;42(3):533-5
[PMID:
16116626
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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