Plasma volume expansion by albumin in cirrhosis. Relation to blood volume distribution, arterial compliance and severity of disease.
OBJECTIVE
The aim of the study was to investigate the effect of a standard albumin load on blood volume distribution, arterial compliance, and the renin-angiotensin-aldosterone system in patients with different degrees of cirrhosis.


METHODS
31 patients with cirrhosis (Child classes A/B/C=8/14/9) received an intravenous infusion of 40 g human serum albumin during a haemodynamic investigation.


RESULTS
Whereas plasma- and blood volume increased by 23 and 15%, respectively (P<0.001), a significant increase in central blood volume was found only in class A patients (+8%, P<0.05), but not in class B or class C patients (+2.7%, not significant (n.s.)). In contrast, arterial compliance only increased significantly in class C patients (+18%, P<0.05), but not in class A or class B patients (+6%, n.s.). Plasma renin activity (PRA) decreased significantly in class C patients (-31%, P<0.05). When all patients were compared, the change in arterial compliance was inversely correlated to the change in PRA (r=-0.50, P<0.01).


CONCLUSIONS
Although infusion of albumin does not expand the central blood volume in patients with advanced cirrhosis, the results indicate a significant improvement in the low effective arterial blood volume of such patients, which may be important in the prevention of circulatory dysfunction.
Brinch
Kim
K
Department of Clinical Physiology, 239, Hvidovre Hospital, University of Copenhagen, DK-2650 Hvidovre, Denmark.
Møller
Søren
S
Bendtsen
Flemming
F
Becker
Ulrik
U
Henriksen
Jens H
JH
D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood; D001158:Arteries / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D003187:Compliance; D005260:Female; D006801:Humans; D008102:Liver Circulation / Q000502:physiology; D008103:Liver Cirrhosis / Q000097:blood* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010953:Plasma Volume / Q000502:physiology*; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System / Q000502:physiology; D012709:Serum Albumin / Q000378:metabolism*; D012720:Severity of Illness Index; D014655:Vascular Resistance / Q000502:physiology
D012709:Serum Albumin; D000450:Aldosterone; D012083:Renin