title: Rapid Bolus Administration Does not Increase The Extravasation Rate of Albumin: A Randomized Controlled Trial in The Endotoxemic Pig.
abstract: Some experimental data suggest that rapid bolus administration of albumin causes less plasma-expanding effects than slow, continuous infusion. To determine whether rapid bolus administration, in comparison with slow infusion, results in greater extravasation of albumin in experimental septic shock we performed a randomized controlled trial with 32 endotoxemic pigs. The animals were monitored and ventilated with standard intensive care equipment and given 10 mL × kg 5% albumin labeled with Technetium-99m, either as a rapid 15-min bolus (Bolus group, n = 16) or as a 2-h infusion (Infusion group, n = 16). Radioactivity was monitored in plasma, extracellular microdialysate, and urine for 6 h. Physiological parameters were monitored hourly. Radioactivity in the liver, spleen, kidney, and lung was analyzed post mortem.The plasma area under the curve activity0-6 h was 4.4 ± 0.9 × 10 in the Bolus group and 4.4 ± 1.1 × 10 counts × min × mL × h in the Infusion group. Blood hemoglobin levels increased in both groups, suggesting severe capillary leakage. Yet, there were no group differences in albumin radioactivity in plasma, muscle tissue, urine, or in the post-mortem analysis of the organs. Following albumin administration, circulatory and respiratory parameters were similar in the two groups.In conclusion, the present results suggest that albumin might be given as a bolus without leading to increased extravasation of albumin, in contrast to previous animal experiments in rodents.
authors.affiliation: *Section of Anesthesiology and Intensive Care, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden †Section of Anesthesiology and Intensive Care, Department of Surgical Sciences, Hedenstierna Laboratory, Uppsala University, Uppsala, Sweden ‡Section of Clinical Chemistry, Department of Medical Sciences, Uppsala University, Uppsala, Sweden §Section of Neurosurgery, Department of Neuroscience, Uppsala University, Uppsala, Sweden ||Department of Medical Physics, University Hospital, Uppsala, Sweden ¶Section of Infectious Diseases, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: von Seth
authors.forename: Miklós
authors.initials: M
authors.lastname: Lipcsey
authors.forename: Peter
authors.initials: P
authors.lastname: Engström
authors.forename: Anders
authors.initials: A
authors.lastname: Larsson
authors.forename: Lars
authors.initials: L
authors.lastname: Hillered
authors.forename: Enn
authors.initials: E
authors.lastname: Maripuu
authors.forename: Charles
authors.initials: C
authors.lastname: Widström
authors.forename: Jan
authors.initials: J
authors.lastname: Sjölin
mesh_terms: D000418:Albumins / Q000008:administration & dosage* / Q000627:therapeutic use*; D000818:Animals; D004334:Drug Administration Schedule; D019446:Endotoxemia / Q000188:drug therapy* / Q000628:therapy; D005440:Fluid Therapy; D006454:Hemoglobins / Q000378:metabolism; D008297:Male; D017551:Microdialysis; D011897:Random Allocation; D013552:Swine
chemical_list: D000418:Albumins; D006454:Hemoglobins