title: Effects of intraperitoneal albumin on systemic and cerebral hemodynamics in a swine model of acute liver failure.
abstract: BACKGROUND
  Currently, albumin dialysis is the most widely used nonbiological liver support system. We hypothesized that direct peritoneal albumin exposure in the peritoneal cavity would stabilize blood flow and prevent liver and brain injury, in the same way that had previously been seen with extracorporeal albumin dialysis systems.
  
  
  METHODS
  Fourteen Landrace pigs (weight 25-30 kg) underwent 70% right hepatectomy and were randomly assigned into a control (C, n = 7) and an intraperitoneal albumin treated group (A, n = 7). The systemic, cerebral, and pulmonary hemodynamic parameters of the animals were recorded at 0, 6, 9, and 12 hr following reperfusion of the liver remnant.
  
  
  RESULTS
  Mean arterial blood pressure, cardiac output, and stroke volume were significantly higher in group A at the end of the experiment. Significantly higher mean intracranial pressure (ICP) values were observed in group C compared to group A, both at 9 hr (21.3 ± 5.2 versus 14.1 ± 3.5 mmHg, p < .0005) and 12 hr (23 ± 4.3 versus 11 ± 3.5 mmHg, p < .0005). On the contrary, cerebral perfusion pressure (CPP) remained stable in albumin-treated groups after the sixth postreperfusion hour. Mean pulmonary artery pressure and pulmonary vascular resistance (PVR) were significantly lower in group A compared to group C at 12 hr, while pulmonary capillary wedge pressure (PCWP) stabilized in albumin-treated animals.
  
  
  CONCLUSIONS
  This study provides the first evidence that intraperitoneal albumin may be able to attenuate systemic, pulmonary, and cerebral hemodynamic disturbances associated with acute liver failure.
authors.affiliation: Fourth Department of Surgery, Attikon University Hospital, Athens, Greece. tympaaliki@yahoo.gr
authors.forename: Aliki
authors.initials: A
authors.lastname: Tympa
authors.forename: Constantinos
authors.initials: C
authors.lastname: Nastos
authors.forename: George
authors.initials: G
authors.lastname: Defterevos
authors.forename: Apostolos
authors.initials: A
authors.lastname: Papalois
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kalimeris
authors.forename: Georgia
authors.initials: G
authors.lastname: Kostopanagiotou
authors.forename: Ioannis
authors.initials: I
authors.lastname: Vassiliou
authors.forename: Vassilios
authors.initials: V
authors.lastname: Smyrniotis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Arkadopoulos
mesh_terms: D000418:Albumins / Q000008:administration & dosage*; D000818:Animals; D001921:Brain / Q000503:physiopathology*; D004195:Disease Models, Animal; D006439:Hemodynamics; D007427:Intracranial Pressure; D017114:Liver Failure, Acute / Q000503:physiopathology / Q000628:therapy*; D010530:Peritoneal Dialysis; D013552:Swine
chemical_list: D000418:Albumins