Effects of albumin supplementation during cardioplegia administration

An in vitro analysis

Rebecca Knox, Alfred H. Stammers, Tunisia Ellis, Chen Gao, Bernadette Nutter, Hunter Holcomb, Ryan Schmer, Lynette M Smith

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Increasing, the colloid osmotic pressure (COP) of blood cardioplegia (BCP) may reduce myocardial edema and preserve cardiac function following cardiopulmonary bypass (CPB). The purpose of this study was to quantify the effects of albumin (ALB) supplementation on cardioplegia COP through an in vitro analysis. A self-contained cardioplegia delivery system administered supplemental ALB to four BCP ratios (1:1, 4:1, 8:1, and 20:1). In Group A, 25% ALB was combined with BCP at four delivery rates (0,13, 25, and 50 mL ALB/L BCP), with a delivery rate of 0 mL ALB/L BCP serving as the control for all groups. Twenty-five percent ALB was added to crystalloid to create carrier solutions containing 12.5, 25, or 50 g ALB/L in Group B, while Group C combined an ALB delivery rate of 50 mL ALB/L BCP with each of the three carrier solutions. Endpoints included initial and post-supplementation hematocrit, total serum protein (TSP), and COP. Without supplemental ALB, TSP was less affected with increasing blood to crystalloid ratios (1:1-81.7 ± 6.2%, 4:1-40.6 ± 5.1%, 8:1-20.6 ± 4.1%, 20:1-6.0 ± 5.7%). The TSP of 1:1 and 4:1 BCP increased (p < .0003 and p < .02) across all methods of supplementation, while 8:1 BCP was similarly increased (p < .008), except with 12.5 and 25 g ALB/L carrier solutions. The greatest change from baseline COP was seen with the lower blood to crystalloid ratios (1:1-64.3 ± 5.0% and 4:1-39.5 ± 10.5%). In higher ratios, the effects of dilution were less profound (14.6 ± 4.2 ± 4.2% and 20:1-6.0 ± 1.9%). COP of 1:1 BCP increased (p < .008) whenever ALB was added. In conclusion, TSP and COP of blood cardioplegic solutions is increased by supplemental albumin administration with quantitative enhancement dependent upon the dilutional effects of the blood to crystalloid ratio.

Original languageEnglish (US)
Pages (from-to)17-23
Number of pages7
JournalJournal of Extra-Corporeal Technology
Volume35
Issue number1
StatePublished - Mar 1 2003

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Induced Heart Arrest
Albumins
Osmotic Pressure
Colloids
Blood Proteins
In Vitro Techniques
Cardiac Edema
Cardioplegic Solutions
Cardiopulmonary Bypass
Hematocrit

Keywords

  • Albumin
  • Colloid oncotic pressure
  • Myocardial edema
  • Myocardial protection

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Effects of albumin supplementation during cardioplegia administration : An in vitro analysis. / Knox, Rebecca; Stammers, Alfred H.; Ellis, Tunisia; Gao, Chen; Nutter, Bernadette; Holcomb, Hunter; Schmer, Ryan; Smith, Lynette M.

In: Journal of Extra-Corporeal Technology, Vol. 35, No. 1, 01.03.2003, p. 17-23.

Research output: Contribution to journalArticle

Knox, R, Stammers, AH, Ellis, T, Gao, C, Nutter, B, Holcomb, H, Schmer, R & Smith, LM 2003, 'Effects of albumin supplementation during cardioplegia administration: An in vitro analysis', Journal of Extra-Corporeal Technology, vol. 35, no. 1, pp. 17-23.
Knox R, Stammers AH, Ellis T, Gao C, Nutter B, Holcomb H et al. Effects of albumin supplementation during cardioplegia administration: An in vitro analysis. Journal of Extra-Corporeal Technology. 2003 Mar 1;35(1):17-23.
Knox, Rebecca ; Stammers, Alfred H. ; Ellis, Tunisia ; Gao, Chen ; Nutter, Bernadette ; Holcomb, Hunter ; Schmer, Ryan ; Smith, Lynette M. / Effects of albumin supplementation during cardioplegia administration : An in vitro analysis. In: Journal of Extra-Corporeal Technology. 2003 ; Vol. 35, No. 1. pp. 17-23.
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abstract = "Increasing, the colloid osmotic pressure (COP) of blood cardioplegia (BCP) may reduce myocardial edema and preserve cardiac function following cardiopulmonary bypass (CPB). The purpose of this study was to quantify the effects of albumin (ALB) supplementation on cardioplegia COP through an in vitro analysis. A self-contained cardioplegia delivery system administered supplemental ALB to four BCP ratios (1:1, 4:1, 8:1, and 20:1). In Group A, 25{\%} ALB was combined with BCP at four delivery rates (0,13, 25, and 50 mL ALB/L BCP), with a delivery rate of 0 mL ALB/L BCP serving as the control for all groups. Twenty-five percent ALB was added to crystalloid to create carrier solutions containing 12.5, 25, or 50 g ALB/L in Group B, while Group C combined an ALB delivery rate of 50 mL ALB/L BCP with each of the three carrier solutions. Endpoints included initial and post-supplementation hematocrit, total serum protein (TSP), and COP. Without supplemental ALB, TSP was less affected with increasing blood to crystalloid ratios (1:1-81.7 ± 6.2{\%}, 4:1-40.6 ± 5.1{\%}, 8:1-20.6 ± 4.1{\%}, 20:1-6.0 ± 5.7{\%}). The TSP of 1:1 and 4:1 BCP increased (p < .0003 and p < .02) across all methods of supplementation, while 8:1 BCP was similarly increased (p < .008), except with 12.5 and 25 g ALB/L carrier solutions. The greatest change from baseline COP was seen with the lower blood to crystalloid ratios (1:1-64.3 ± 5.0{\%} and 4:1-39.5 ± 10.5{\%}). In higher ratios, the effects of dilution were less profound (14.6 ± 4.2 ± 4.2{\%} and 20:1-6.0 ± 1.9{\%}). COP of 1:1 BCP increased (p < .008) whenever ALB was added. In conclusion, TSP and COP of blood cardioplegic solutions is increased by supplemental albumin administration with quantitative enhancement dependent upon the dilutional effects of the blood to crystalloid ratio.",
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AU - Schmer, Ryan

AU - Smith, Lynette M

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N2 - Increasing, the colloid osmotic pressure (COP) of blood cardioplegia (BCP) may reduce myocardial edema and preserve cardiac function following cardiopulmonary bypass (CPB). The purpose of this study was to quantify the effects of albumin (ALB) supplementation on cardioplegia COP through an in vitro analysis. A self-contained cardioplegia delivery system administered supplemental ALB to four BCP ratios (1:1, 4:1, 8:1, and 20:1). In Group A, 25% ALB was combined with BCP at four delivery rates (0,13, 25, and 50 mL ALB/L BCP), with a delivery rate of 0 mL ALB/L BCP serving as the control for all groups. Twenty-five percent ALB was added to crystalloid to create carrier solutions containing 12.5, 25, or 50 g ALB/L in Group B, while Group C combined an ALB delivery rate of 50 mL ALB/L BCP with each of the three carrier solutions. Endpoints included initial and post-supplementation hematocrit, total serum protein (TSP), and COP. Without supplemental ALB, TSP was less affected with increasing blood to crystalloid ratios (1:1-81.7 ± 6.2%, 4:1-40.6 ± 5.1%, 8:1-20.6 ± 4.1%, 20:1-6.0 ± 5.7%). The TSP of 1:1 and 4:1 BCP increased (p < .0003 and p < .02) across all methods of supplementation, while 8:1 BCP was similarly increased (p < .008), except with 12.5 and 25 g ALB/L carrier solutions. The greatest change from baseline COP was seen with the lower blood to crystalloid ratios (1:1-64.3 ± 5.0% and 4:1-39.5 ± 10.5%). In higher ratios, the effects of dilution were less profound (14.6 ± 4.2 ± 4.2% and 20:1-6.0 ± 1.9%). COP of 1:1 BCP increased (p < .008) whenever ALB was added. In conclusion, TSP and COP of blood cardioplegic solutions is increased by supplemental albumin administration with quantitative enhancement dependent upon the dilutional effects of the blood to crystalloid ratio.

AB - Increasing, the colloid osmotic pressure (COP) of blood cardioplegia (BCP) may reduce myocardial edema and preserve cardiac function following cardiopulmonary bypass (CPB). The purpose of this study was to quantify the effects of albumin (ALB) supplementation on cardioplegia COP through an in vitro analysis. A self-contained cardioplegia delivery system administered supplemental ALB to four BCP ratios (1:1, 4:1, 8:1, and 20:1). In Group A, 25% ALB was combined with BCP at four delivery rates (0,13, 25, and 50 mL ALB/L BCP), with a delivery rate of 0 mL ALB/L BCP serving as the control for all groups. Twenty-five percent ALB was added to crystalloid to create carrier solutions containing 12.5, 25, or 50 g ALB/L in Group B, while Group C combined an ALB delivery rate of 50 mL ALB/L BCP with each of the three carrier solutions. Endpoints included initial and post-supplementation hematocrit, total serum protein (TSP), and COP. Without supplemental ALB, TSP was less affected with increasing blood to crystalloid ratios (1:1-81.7 ± 6.2%, 4:1-40.6 ± 5.1%, 8:1-20.6 ± 4.1%, 20:1-6.0 ± 5.7%). The TSP of 1:1 and 4:1 BCP increased (p < .0003 and p < .02) across all methods of supplementation, while 8:1 BCP was similarly increased (p < .008), except with 12.5 and 25 g ALB/L carrier solutions. The greatest change from baseline COP was seen with the lower blood to crystalloid ratios (1:1-64.3 ± 5.0% and 4:1-39.5 ± 10.5%). In higher ratios, the effects of dilution were less profound (14.6 ± 4.2 ± 4.2% and 20:1-6.0 ± 1.9%). COP of 1:1 BCP increased (p < .008) whenever ALB was added. In conclusion, TSP and COP of blood cardioplegic solutions is increased by supplemental albumin administration with quantitative enhancement dependent upon the dilutional effects of the blood to crystalloid ratio.

KW - Albumin

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