title: Plasma volume expansion with 5% albumin compared to Ringer's acetate during normal and increased microvascular permeability in the rat.
abstract: BACKGROUND
  It is believed that the effectiveness of colloids as plasma volume expanders is dependent on the endothelial permeability for macromolecules. The objective of this study was to test the hypothesis that the plasma volume expanding effect of 5% albumin relative to that of a crystalloid solution is reduced if microvascular permeability is increased.
  
  
  METHODS
  A control group was resuscitated with either 5% albumin (8 ml/kg) or Ringer's acetate (36 ml/kg) immediately after a hemorrhage of 8 ml/kg (n = 29). In a second group, permeability was increased by inducing sepsis through cecal ligation and incision (n = 28). Three hours after cecal ligation and incision, the animals were resuscitated with either 5% albumin in a ratio of 1:1 relative to the volume of lost plasma, or Ringer's acetate in a ratio of 4.5:1.
  
  
  RESULTS
  In the hemorrhage group, plasma volumes at 15 min after resuscitation with albumin or Ringer's acetate had increased by 9.8 ± 2.6 ml/kg (mean ± SD) and 7.4 ± 2.9 ml/kg and were similar at 2 and 4 h. Plasma volume 3 h after cecal ligation and incision had decreased by approximately 7 ml/kg, and at 15 min after resuscitation with albumin or Ringer's acetate it had increased by 5.7 ± 2.9 and 2.4 ± 3.0 ml/kg, respectively (P < 0.05). At 2 and 4 h after resuscitation, plasma volumes did not differ between the groups.
  
  
  CONCLUSIONS
  This study does not support the hypothesis that the plasma-volume-expanding effect of albumin relative to that of crystalloids is decreased under conditions characterized by increased permeability.
authors.affiliation: From the Department of Anesthesia and Intensive Care, University of Lund and Lund University Hospital, Lund, Sweden (P. Bansch, S.S., P. Bentzer); and Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada (P. Bentzer).
authors.forename: Peter
authors.initials: P
authors.lastname: Bansch
authors.forename: Svajunas
authors.initials: S
authors.lastname: Statkevicius
authors.forename: Peter
authors.initials: P
authors.lastname: Bentzer
mesh_terms: D000818:Animals; D002199:Capillary Permeability / Q000187:drug effects* / Q000502:physiology; D006470:Hemorrhage / Q000188:drug therapy / Q000378:metabolism; D006801:Humans; D007552:Isotonic Solutions / Q000378:metabolism / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008833:Microcirculation / Q000187:drug effects* / Q000502:physiology; D010952:Plasma Substitutes / Q000378:metabolism / Q000494:pharmacology*; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D018805:Sepsis / Q000188:drug therapy / Q000378:metabolism; D012709:Serum Albumin / Q000378:metabolism / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D007552:Isotonic Solutions; D010952:Plasma Substitutes; C028570:Ringer's acetate; D012709:Serum Albumin