26.05.2022 | Correspondence
Ten myths about albumin: do not forget the endothelium
verfasst von:
Geoffroy Hariri, Jeremie Joffre, Eric Maury, Bertrand Guidet, Hafid Ait-Oufella
Erschienen in:
Intensive Care Medicine
|
Ausgabe 8/2022
Einloggen, um Zugang zu erhalten
Excerpt
We read with great interest the study by Joannidis et al. [
1] about common belief of human serum albumin (HSA) effect in different settings. We really appreciate the review but we would like to stress that the authors did not discuss about the protective effects of albumin on microvascular endothelial cell function, a key determinant of organ perfusion in sepsis context. In a recent pilot study on resuscitated septic shock patients [
2], we recently compared the impact of HSA infusion versus saline on microvascular endothelial function. Variations of blood pressure as well as cardiac output after infusion were similar between groups but we found that HAS strongly improved acetylcholine-induced endothelial response. The vascular beneficial effect of HSA was also found in a sub-study of ALBIOS trial including 375 septic shock patients. Interestingly, the authors described that soluble level of vascular endothelial (VE), shed from the endothelium, was decreased in patients receiving HSA [
3], suggesting a benefit effect on the vascular wall permeability. The protective vascular effects of albumin may not be limited to sepsis context. In a murine model of hemorrhagic shock, albumin administration improved mesenteric microcirculatory blood flow and tissue perfusion [
4]. …