Changes in acid-base balance following bolus infusion of 20% albumin solution in humans.
OBJECTIVE
To evaluate changes in acid-base balance following bolus infusions of a 20% albumin solution.


METHODS
Randomized prospective study in a university hospital.


METHODS
Two groups of eight patients each undergoing gynecological surgery.


METHODS
Patients were randomly assigned to receive either 0.9% saline or lactated Ringer's solution. At the end of surgery two boluses of 0.5 g/kg body weight of a 20% albumin solution were administered. Arterial blood gases, electrolytes, and total protein were measured. The strong ion difference and the amount of weak plasma acid were calculated. pH and titratable acidity of the 20% albumin solution were determined.


RESULTS
The infusion of a 20% albumin solution resulted in a significant decrease in pH from 7.284 to 7.262 in the saline group and from 7.422 to 7.394 in the Ringer's group. In both groups the 20% albumin solution caused an increase in strong ion difference and an increase in the amount of weak plasma acid. The observed changes in serum bicarbonate concentration were in good agreement with the changes in strong ion difference and the amount of weak plasma acid. The 20% albumin solution possessed a pH of 6.95 and a titratable acidity of 8.5 [corrected] mEq/l.


CONCLUSIONS
According to the Stewart approach, the observed changes in acid-base balance are the net result of the two opposing effects of the strong ion difference and the amount of weak plasma acid. Alternatively, the acidifying effect of the 20% albumin solution may stem from the titratable acid content of the solution.
Clinic of Anesthesiology, Ludwig-Maximilians-University, Marchioninistrasse 15, 81377 Munich, Germany.
Dirk
D
Bruegger
Matthias
M
Jacob
Stefan
S
Scheingraber
Peter
P
Conzen
Bernhard F
BF
Becker
Udilo
U
Finsterer
Markus
M
Rehm
D000136:Acid-Base Equilibrium / Q000187:drug effects*; D000328:Adult; D000418:Albumins / Q000008:administration & dosage* / Q000627:therapeutic use; D001784:Blood Gas Analysis; D004573:Electrolytes / Q000008:administration & dosage / Q000627:therapeutic use; D013509:Gynecologic Surgical Procedures; D006785:Hospitals, University; D006801:Humans; D006863:Hydrogen-Ion Concentration / Q000187:drug effects; D019344:Lactic Acid / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome; D014882:Water-Electrolyte Balance / Q000187:drug effects
D000418:Albumins; D004573:Electrolytes; D019344:Lactic Acid; D012965:Sodium Chloride