4 Albumin, the natural colloid: experimental data and clinical implications

The fluid replacement chosen for surgical applications and shock resuscitation continues to be debated. Historically, the controversy is centred on the use of colloid versus electrolyte solutions. Studies of electrolyte solutions in resuscitation often utilize a model of haemorrhagic shock, while colloid solution study models generally involve septic or ischaemic shock, with corresponding loss of plasma proteins.

Survival variables and resuscitation criteria are main factors in evaluating infusion agents in clinical practice. The colloid dose-volume-concentration relationship is crucial in extrapolating experimental studies to clinical applications, as failure to consider any variable may result in mortality.

Principles of albumin dosing, volume and concentration are related to survival variables in experimental plasma loss types of shock. The derivations of these principles have been tested clinically using renal transplantation as a unique single organ clinical shock model, evaluating the importance of colloid administration in early optimization of organ function and graft survival.