21422This randomised, double-blind, crossover relative comparative efficacy study evaluated common crystalloids (0.9% saline and Hartmann’s solution), 4% albumin, and the low-volume 20% albumin solution in IV fluid resuscitation.
Six healthy euvolaemic men under the age of 40 years were administered each fluid, at the same rate and with intervals of at least one week, and were tested for lung and heart function and haemodynamics.
Interstitial pulmonary oedema occurred upon administration of crystalloids, with lung injury also present after infusion of the 0.9% saline solution, whereas use of colloid albumin was associated with decreased lung volume and increased diffusion capacity without oedema.
Except for 20% albumin, all the fluids induced a drop in body temperature, which may have resulted in decreased left ventricle contractility, and the cardiac assessment revealed increased cardiac output and stroke volume with colloid infusion.
Kidney function was not negatively affected by any of the fluids despite an increase in chloride concentration and a decrease in bicarbonate concentration with 0.9% saline and 4% albumin.
The authors believe that 20% albumin is an effective and safe alternative under the conditions evaluated; however, an increased stroke work may constitute a cause of concern in patients with pre-existing heart conditions.
