Effects of intraperitoneal albumin on systemic and cerebral hemodynamics in a swine model of acute liver failure.

Abstract

BACKGROUND:

Currently, albumin dialysis is the most widely used nonbiological liver support system. We hypothesized that direct peritoneal albumin exposure in the peritoneal cavity would stabilize blood flow and prevent liver and brain injury, in the same way that had previously been seen with extracorporeal albumin dialysis systems.

MATERIALS AND METHODS:

Fourteen Landrace pigs (weight 25-30 kg) underwent 70% right hepatectomy and were randomly assigned into a control (C, n = 7) and an intraperitoneal albumin treated group (A, n = 7). The systemic, cerebral, and pulmonary hemodynamic parameters of the animals were recorded at 0, 6, 9, and 12 hr following reperfusion of the liver remnant.

RESULTS:

Mean arterial blood pressure, cardiac output, and stroke volume were significantly higher in group A at the end of the experiment. Significantly higher mean intracranial pressure (ICP) values were observed in group C compared to group A, both at 9 hr (21.3 ± 5.2 versus 14.1 ± 3.5 mmHg, p < .0005) and 12 hr (23 ± 4.3 versus 11 ± 3.5 mmHg, p < .0005). On the contrary, cerebral perfusion pressure (CPP) remained stable in albumin-treated groups after the sixth postreperfusion hour. Mean pulmonary artery pressure and pulmonary vascular resistance (PVR) were significantly lower in group A compared to group C at 12 hr, while pulmonary capillary wedge pressure (PCWP) stabilized in albumin-treated animals.

CONCLUSIONS:

This study provides the first evidence that intraperitoneal albumin may be able to attenuate systemic, pulmonary, and cerebral hemodynamic disturbances associated with acute liver failure.

• Authors: Aliki Tympa, Constantinos Nastos, George Defterevos, Apostolos Papalois, Konstantinos Kalimeris, Georgia Kostopanagiotou, Ioannis Vassiliou, Vassilios Smyrniotis, Nikolaos Arkadopoulos
• Journal: Journal of investigative surgery : the official journal of the Academy of Surgical Research (J Invest Surg) Vol. 24 Issue 3 Pg. 129-33 ( 2011) ISSN: 1521-0553 [Electronic] United States
• PMID: 21524179 (Publication Type: Journal Article)

Chemical References

• Albumins

Topics

• Albumins (administration & dosage)
• Animals
• Brain (physiopathology)
• Disease Models, Animal
• Hemodynamics
• Intracranial Pressure
• Liver Failure, Acute (physiopathology, therapy)
• Peritoneal Dialysis
• Swine