Human albumin is the most important oncotic-active
protein (1 g
albumin attaches 18 g water). It is essential for the water exchange between intra- and extracellular space and for homeostasis. The physiological distribution of
albumin, its daily exchange and degradation are being discussed. At the example of normo- and hypovolaemic patients and acute blood-loss the stabilising effect on the blood-volume and the hemodynamic efficacy of
human albumin are shown.
Human albumin was infused into patients with
hypoproteinemia and hypovolaemia as well as to surgical patients with normovolaemia. Volunteers received
albumin after an acute blood-loss. Under and after the
albumin-infusion the
albumin disappeared partly from the blood-stream. The loss to the extravascular compartments was greatest among patients with
hypoproteinemia. Among volunteers with experimental blood-loss the infused volume disappeared in an amount of 45 to 106 ml per hour. When
human albumin is given over a longer period the synthesis of endogenous
albumin and of
globulins may be inhibited or at least depressed.
Albumin has a positive effect on the hemodynamic. The cardiac-output and the stroke volume increased. The peripheral resistance fell in the same time. Renal filtration rate and the urine volume increased, in contrast renal resistance was lowered.