Albumin-Beyond Fluid Replacement in Cardiopulmonary Bypass Surgery: Why, How, and When?

摘要: Maintaining vascular barrier competence, preventing interstitial edema, and keeping microcirculation intact is crucial to achieve an optimal outcome in cardiopulmonary bypass surgery (CPB). Blood contact with roller pumps foreign surfaces during CPB induces shear stress a pressure drop across the pump boot that leads transient systemic activation of inflammatory hemostatic systems. Moreover, patients after often need volume resuscitation using smallest possible amount colloid solution because fluid overload. For this purpose, human-derived albumin may be preferred over synthetic colloids priming preserves oncotic pressure, prevents platelet adhesion, likely less consumption coagulation factors. In increased bleeding or renal failure, safe alternative its minimal side effects. Large, randomized clinical trials comparing benefit versus other fluids are warranted future define albumin's distinct role select high-risk surgical populations.