临床实践中的 25% 人血白蛋白溶液:适应症、风险和监测方案。

IF 1.9 Q3 GASTROENTEROLOGY & HEPATOLOGY Minerva gastroenterology Pub Date : 2024-01-01 DOI:10.23736/S2724-5985.24.03826-9
Carmine Gambino, Paolo Angeli
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引用次数: 0

摘要

人血白蛋白溶液是一种常用的治疗药物,因为它能够在各种临床环境中扩大血浆容量并改善肿瘤压,例如肝硬化和败血症患者,这些患者的治疗是一大挑战。尽管没有证据表明人血白蛋白溶液在改善主要预后方面优于晶体液,但在恢复肝硬化和败血症引起的低血压患者的全身血液动力学和实现较低的每日净体液平衡方面,短期使用人血白蛋白溶液似乎比生理盐水和血浆蛋白更有效。使用 25% 人血白蛋白溶液还能有效控制肝硬化患者的腹水,减少输液量,更快地达到血浆目标浓度。本文旨在全面回顾使用人血白蛋白溶液的适应症,研究相关风险,并概述监测接受这种治疗的患者的最佳方法,以确保患者获得最佳治疗效果,同时将不良反应降至最低。
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Twenty-five percent human albumin solution in clinical practice: indications, risks and monitoring protocols.

Human albumin solution is a commonly used therapeutic agent because of its ability to expand plasma volume and improve oncotic pressure in various clinical settings, such as in patients with cirrhosis and sepsis, whose management is a major challenge. Despite the lack of evidence for the superiority of human albumin solutions compared with crystalloids in improving major outcomes, short-term administration of human albumin solution appears to be more effective than both saline and plasmalyte in recovering systemic hemodynamics and achieving a lower daily net fluid balance in patients with cirrhosis and sepsis-induced hypotension. The use of 25% human albumin solution could also effectively manage ascites in patients with cirrhosis, reducing the volume of fluids administered and allowing a faster achievement of the plasma target concentration. This article aims to comprehensively review the indications for the use of human albumin solutions, examine the associated risks, and outline best practices for monitoring patients receiving this treatment, ensuring optimal patient outcomes while minimizing adverse effects.

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