альбумин в прайме

[minin sergey]

коллеги, хотелось бы уточнить, нет ли у кого информации о микро дозах альбумина в прайме и их влияние на тромбоциты? нажел в гугле пару статей, мб исчо кто чаво подскажет? Мб кто-то использует?

http://www.ncbi.nlm.nih.gov/pubmed/10411245

http://www.area-c54.it/public/albumin%2 ... urgery.pdf

[Alexey Dyachkov]

Ну вот такие статейки

Journal of Cardiothoracic and Vascular Anesthesia
Volume 24, Issue 3, 2010, Pages 422-426
ISSN: 10530770
CODEN: JCVAE
DOI: 10.1053/j.jvca.2009.10.018
PubMed ID: 20056447
Document Type: Article
Source Type: Journal

Profound Effects of Cardiopulmonary Bypass Priming Solutions on the Fibrin Part of Clot Formation: An Ex Vivo Evaluation Using Rotation Thromboelastometry

Brinkman, A.C.M.a , Romijn, J.W.A.a , van Barneveld, L.J.M.b , Greuters, S.a , Veerhoek, D.b , Vonk, A.B.A.b , Boer, C.a Email this author Correspondence address

a Department of Anesthesiology, Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, Netherlands
b Department of Cardiothoracic Surgery, Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, Netherlands

Abstract

Objectives: Dilutional coagulopathy as a consequence of cardiopulmonary bypass (CPB) system priming may also be affected by the composition of the priming solution. The direct effects of distinct priming solutions on fibrinogen, one of the foremost limiting factors during dilutional coagulopathy, have been minimally evaluated. Therefore, the authors investigated whether hemodilution with different priming solutions distinctly affects the fibrinogen-mediated step in whole blood clot formation. Design: Prospective observational laboratory study. Setting: University hospital laboratory. Participants: Eight male healthy volunteers. Interventions: Blood samples diluted with gelatin-, albumin-, or hydroxyethyl starch (HES)-based priming solutions were ex-vivo evaluated for clot formation by rotational thromboelastometry. Measurements and Main Results: The intrinsic pathway (INTEM) coagulation time increased from 186 ± 19 seconds to 205 ± 16, 220 ± 17, and 223 ± 18 seconds after dilution with gelatin-, albumin-, or HES-containing prime solutions (all p < 0.05 v baseline). The extrinsic pathway (EXTEM) coagulation time was only minimally affected by hemodilution. Moreover, all 3 priming solutions significantly reduced the INTEM and EXTEM maximum clot firmness. The HES-containing priming solution induced the largest decrease in the maximum clot firmness attributed to fibrinogen, from 13 ± 1 mm (baseline) to 6 ± 1 mm (p < 0.01 v baseline). Conclusions: All studied priming solutions prolonged coagulation time and decreased clot formation, but the fibrinogen-limiting effect was the most profound for the HES-containing priming solution. These results suggest that the composition of priming solutions may distinctly affect blood clot formation, in particular with respect to the fibrinogen component in hemostasis.

© 2010 Elsevier Inc. All rights reserved.

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Cardiopulmonary bypass priming using a high dose of a balanced hydroxyethyl starch versus an albumin-based priming strategy (Retraction in: Anesthesia and Analgesia (2010) 11:6 (1567))

Boldt, J.Email this author, Suttner, S., Brosch, C., Lehmann, A., Röhm, K., Mengistu, A. Correspondence address

Department of Anesthesiology and Intensive Care Medicine, Klinikum der Stadt Ludwigshafen, Bremserstr. 79, D-67063 Ludwigshafen, Germany

Abstract

BACKGROUND: The optimal priming solution for cardiopulmonary bypass (CPB) is unclear. In this study, we evaluated the influence of high-volume priming with a modern balanced hydroxyethyl starch (HES) preparation on coagulation, inflammation, and organ function compared with an albumin-based CPB priming regimen. METHODS: In 50 patients undergoing coronary artery bypass grafting, the CPB circuit was prospectively and randomly primed with either 1500 mL of 6% HES 130/0.42 in a balanced electrolyte solution (Na 140 mmol/L, Cl 118 mmol/L, K 4 mmol/L, Ca 2.5 mmol/L, Mg 1 mmol/L, acetate 24 mmol/L, malate 5 mmol/L) (n = 25) or with 500 mL of 5% human albumin plus 1000 mL 0.9% saline solution (n = 25). Inflammation (interleukins [IL]-6, -10), endothelial damage (soluble intercellular adhesion molecule-1), kidney function (kidney-specific proteins α-glutathione S-transferase, neutrophil gelatinase-associated lipocalin), coagulation (measured by thrombelastometry [ROTEM®, Pentapharm, Munich, Germany]), and platelet function (measured by whole blood aggregometry [Multiplate® analyzer, Dynabyte Medical, Munich, Germany]) were assessed after induction of anesthesia, immediately after surgery, 5 h after surgery, and on the morning of first and second postoperative days. RESULTS: Total volume given during and after CPB was 3090 ± 540 mL of balanced HES and 3110 ± 450 mL of albumin. Base excess after surgery was lower in the albumin-based priming group than in the balanced HES priming group (-5.9 ± 1.2 mmol/L vs +0.2 ± 0.2 mmol/L, P = 0.0003). Plasma levels of IL-6, IL-10, and intercellular adhesion molecule-1 were higher after CPB in the albumin-based priming group compared with the HES priming group at all time periods (P = 0.0002). Urinary concentrations of α-glutathione S-transferase and neutrophil gelatinase-associated lipocalin were higher after CPB through the end of the study in the albumin group compared with the balanced HES group (P = 0.00004). After surgery through the first postoperative day, thrombelastometry data (clotting time and clot formation time) revealed more impaired coagulation in the albumin-based priming group compared with the HES priming group (P = 0.004). Compared with baseline, platelet function was unchanged in the high-dose balanced HES priming group after CPB and 5 h after surgery, but it was significantly reduced in the albumin-based priming group. CONCLUSION: High-volume priming of the CPB circuit with a modern balanced HES solution resulted in reduced inflammation, less endothelial damage, and fewer alterations in renal tubular integrity compared with an albumin-based priming. Coagulation including platelet function was better preserved with high-dose balanced HES CPB priming compared with albumin-based CPB priming.

© 2009 International Anesthesia Research Society.

[minin sergey]

сомневаюсь касательно второй статейки... йоахим болТ обсуждался где-то тут...