A comparison of albumin-bolus therapy versus normal saline-bolus therapy for hypotension in neonates.
OBJECTIVE
We compared responses to bolus infusion of 5% albumin (ALB) or normal saline (NS) for hypotension in neonates.


METHODS
Hypotensive infants were given 10 ml kg(-1) of NS or ALB. A second bolus was given for persistent hypotension. Dopamine therapy was started for hypotension after the second bolus. The primary response was increase in arterial blood pressure toward normal range 1 h postinfusion. Secondary measures included duration of normotension, meeting criteria for second bolus, meeting criteria for vasopressor support and cost comparison.


RESULTS
Those receiving ALB (N=49 ALB and 52 NS) were more likely to achieve a normotensive state (ALB=57.1%, NS=32.1% P=0.01) 1 h following the initial bolus therapy. Subsequently, the NS group was also more likely to qualify for vasopressor infusion (ALB=24.5%, NS=44.2% P=0.02). Overall cost for either therapy was equivalent.


CONCLUSIONS
In hypotensive neonates, ALB results in a greater likelihood of achieving normotension and decreased subsequent use of vasopressors when compared to NS.
Lynch
S K
SK
Department of Pediatrics, Section of Neonatology, West Virginia University School of Medicine, Morgantown, WV 26506, USA. slynch@hsc.wvu.edu
Mullett
M D
MD
Graeber
J E
JE
Polak
M J
MJ
D000418:Albumins / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007022:Hypotension / Q000188:drug therapy*; D007231:Infant, Newborn; D007262:Infusions, Intravenous / Q000379:methods; D007363:Intensive Care Units, Neonatal; D008297:Male; D012965:Sodium Chloride / Q000008:administration & dosage*; D016896:Treatment Outcome
D000418:Albumins; D012965:Sodium Chloride