title: [Current role of albumin in critical care].
abstract: The use of colloids in fluid therapy has been, and still continues to be a controversial topic, particularly when referring to the critical patient. The choice of the fluid that needs to be administered depends on several factors, many of which are theoretical, and continue being an object of debate. The interest in the clinical use of the albumin has emerged again, immediately after recent publications in the search of the most suitable colloid. It is the most abundant protein in the plasma, being responsible for 80% of the oncotic pressure. It regulates the balance between the intra- and extra-vascular volumes. Recent multicenter studies question the supposed lack of safety that was previously assigned to it. Furthermore, in vitro studies demonstrate other important actions besides oncotic, for example neutralization of free radicals, and exogenous (drugs) and endogenous substances (bile pigments, cholesterol). Being aware of these secondary properties of albumin, and evaluating the pathophysiology of the critical patient (in particular, sepsis), to maintain plasma albumin levels within the normal range, could be of great importance. Based on the most recent publications, the aim of this review is to briefly analyze the pathophysiology of albumin, as well as to discuss its possible indications in the critical patient.
authors: Servicio de Anestesiología y Reanimación, Hospital Xeral-Cíes, Vigo, Pontevedra, España. Electronic address: pilaraguirrepuig@yahoo.es.
authors: P
authors: P
authors: Aguirre Puig
authors: Servicio de Anestesiología y Reanimación, Hospital Xeral-Cíes, Vigo, Pontevedra, España.
authors: M A
authors: MA
authors: Orallo Morán
authors: Servicio de Anestesiología y Reanimación, Hospital Xeral-Cíes, Vigo, Pontevedra, España.
authors: D
authors: D
authors: Pereira Matalobos
authors: Servicio de Anestesiología y Reanimación, Hospital Xeral-Cíes, Vigo, Pontevedra, España.
authors: P
authors: P
authors: Prieto Requeijo
mesh_terms: D000070642:Brain Injuries, Traumatic / Q000628:therapy; D002056:Burns / Q000628:therapy; D002986:Clinical Trials as Topic; D003102:Colloids; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D019317:Evidence-Based Medicine; D005440:Fluid Therapy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D034141:Hypoalbuminemia / Q000209:etiology / Q000628:therapy; D008103:Liver Cirrhosis / Q000628:therapy; D015201:Meta-Analysis as Topic; D015337:Multicenter Studies as Topic; D064887:Observational Studies as Topic; D012128:Respiratory Distress Syndrome / Q000628:therapy; D018805:Sepsis / Q000097:blood / Q000628:therapy; D012709:Serum Albumin / Q000009:adverse effects / Q000502:physiology / Q000627:therapeutic use*
chemical_list: D003102:Colloids; D012709:Serum Albumin
keywords: Albumin; Albumin and critical care; Albumin and sepsis; Albúmina; Albúmina y cuidados críticos; Albúmina y sepsis; Colloid and critical care; Coloides y cuidados críticos; Fluid therapy; Fluidoterapia; Hipoalbuminemia y cuidados críticos; Hypoalbuminemia and critical care