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Current Concepts in Fluid Resuscitation and Vasopressor Use in Cirrhosis.
Semin Liver Dis
January 2025
Hepatology, University of Pennsylvania, Philadelphia, United States.
Critically ill patients with cirrhosis and liver failure not uncommonly have hypotension due to multifactorial reasons, that include hyperdynamic state with increased cardiac index, low systemic vascular resistance due to portal hypertension, following the use of beta blocker or diuretic therapy, and severe sepsis. These changes are mediated by microvascular alterations in the liver, systemic inflammation, activation of renin angiotensin aldosterone system, and vasodilatation due to endothelial dysfunction. Hemodynamic assessment includes measuring inferior vena cava indices, cardiac output and systemic vascular resistance using point-of-care ultrasound (POCUS), in addition to arterial waveform analysis, or pulmonary artery pressures, and lactate clearance to guide fluid resuscitation.
View Article and Find Full Text PDFA Randomized Controlled Trial on the Efficacy of 20% Human Albumin in Reducing Pleural Effusion After Cardiopulmonary Bypass.
J Clin Med
December 2024
Department of Cardiovascular Anesthesia and Intensive Care, Pauls Stradins Clinical University Hospital, LV-1002 Riga, Latvia.
: Cardiopulmonary bypass can lead to hemodilution, causing a fluid shift to the interstitial space. Albumin helps counteract the intravascular fluid movement to the extravascular space and reduces the risk of complications associated with fluid imbalance. Our main objective was to evaluate the effectiveness of albumin addition in the cardiopulmonary bypass priming solution compared to standard priming, focusing on its role in reducing pleural effusion development.
View Article and Find Full Text PDFAssociation between serum albumin levels at admission and clinical outcomes in pediatric intensive care units: a multi-center study.
BMC Pediatr
December 2024
Department of Pediatric Intensive Care, Faculty of Medicine, Cukurova University, Adana, Turkey.
Background: Albumin, a vital component in regulating human blood oncotic pressure, plays an important role in the prediction of prognosis in pediatric patients.Previous research identified significant differences in serum albumin levels of healthy and critically ill children.
Methods: The present study aims to investigate the correlation between albumin levels measured during pediatric intensive care unit(PICU) admission and clinical outcomes.
Beyond the Barriers of Ex Vivo Lung Perfusion Through an Emblematic Case: A New Way Forward to Expand the Donor Pool.
J Clin Med
December 2024
Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy.
Lung transplantation is the most effective treatment for end-stage respiratory diseases, but its application is limited by the shortage of organs. Ex vivo lung perfusion (EVLP) has emerged as a promising technique to evaluate and recondition donor lungs previously deemed unsuitable for transplantation. However, limitations such as lung contusions, air leaks, and perfusate extravasation, especially in portable EVLP systems, hinder the procedure.
View Article and Find Full Text PDFOptical sensing of albumin in human serum and urine-A historical review of the transition from classical dye-binding assays to advanced technologies.
Int J Biol Macromol
January 2025
Division of Food Sciences, Institute of Animal Reproduction and Food Research of the Polish Academy of Sciences, Street Tuwima 10, 10-748 Olsztyn, Poland. Electronic address:
Human serum albumin (HSA) is the most abundant protein in human plasma playing essential roles in transporting various biomolecules, metal ions, therapeutic agents, and metabolites. Additionally, it is crucial for maintaining oncotic pressure, scavenging free radicals, and preventing protein aggregation. Accurate quantification of HSA is vital for diagnosing various conditions, including hypertension, diabetes mellitus (DM), liver disorders, and renal diseases.
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