Albumin therapy in clinical practice.
Albumin therapy in clinical practice.
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DOI：
10.1177/0115426505020003314
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发表时间：
2005-06-01
期刊：
影响因子：
--
通讯作者：
Marsano, Luis S
中科院分区：
文献类型：
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作者：
Mendez, Christian M;McClain, Craig J;Marsano, Luis S
白蛋白是肝脏蛋白质合成的主要产物，也是含量更高的血浆蛋白之一。在其多种生理作用中，它在胶体-粘附压力的产生中起着重要作用。在美国，白蛋白治疗的适应症包括血容量不足或休克、烧伤、低白蛋白血症、手术或创伤、心肺转流术、急性呼吸窘迫综合征、血液透析和富含蛋白质的液体隔离。在某些医院，这种相对昂贵的疗法的使用占总药房预算的30%。在多项随机对照试验和荟萃分析中，对白蛋白治疗在不同临床情况下的使用及其对发病率和死亡率的影响进行了综述。尽管经常审查，白蛋白的使用在几种临床情况下仍然存在争议。同时，这些有价值的综述似乎已经证明了白蛋白治疗在腹水管理中的优势，并阐明了白蛋白在容量复苏中的应用。建议进行更多研究，以研究不同剂量白蛋白的使用及其在低白蛋白血症中的作用。本文将概述白蛋白代谢、白蛋白用于扩容、白蛋白在肝病中的潜在治疗作用以及白蛋白治疗在营养中的作用。
Albumin is the predominant product of hepatic protein synthesis and one of the more abundant plasma proteins. Among its multiple physiologic roles, it plays an essential part in the generation of colloid-oncotic pressure. In the United States, the indications for which albumin therapy are considered include hypovolemia or shock, burns, hypoalbuminemia, surgery or trauma, cardiopulmonary bypass, acute respiratory distress syndrome, hemodialysis, and sequestration of protein-rich fluids. The use of this relatively expensive therapy accounts for up to 30% of the total pharmacy budget in certain hospitals. The use of albumin therapy in different clinical situations and its influence in morbidity and mortality have been reviewed in multiple randomized controlled trials and meta-analyses. Despite frequent reviews, the use of albumin remains controversial in several clinical situations. At the same time, these valuable reviews seem to have documented the advantages of albumin therapy in the management of ascites and clarified the use of albumin in volume resuscitation. More studies have been recommended to investigate the use of albumin in different doses and its role in hypoalbuminemia. This article will provide an overview of albumin metabolism, use of albumin for volume expansion, the potential therapeutic role of albumin in liver disease, and the role of albumin therapy in nutrition.