Hallowell P, Bland J H, Dalton B C, Erdmann A J, Lappas D G, Laver M B, Philbin D, Thomas S, Lowenstein E
Ann Thorac Surg. 1978 Jan;25(1):22-9. doi: 10.1016/s0003-4975(10)63481-9.
To determine the effect of intraoperative albumin administration on blood use, water balance, and postoperative clinical course, we studied two groups of adult cardiac surgical patients. Group I (30 patients) received 25 gm of albumin during withdrawal of 2 units of blood prior to cardiopulmonary bypass (CPB) and 50 gm of albumin in the oxygenator prime. Group II (32 patients) received no albumin prior to the end of CPB. No difference in clinical course could be identified, nor was there a significant difference in blood use. Group I patients had lower hematocrit values intraoperatively from the time of blood withdrawal until the conclusion of operation. Coronary artery bypass operations were associated with greater positive water balance than were heat valve operations. Forty-three percent of the patients having coronary artery bypass grafting had a positive water balance greater than 5 liters, whereas 50% of those undergoing valve procedures had a balance less than 3 liters. We conclude that the principal effect of withholding albumin under these circumstances is to increase net positive water balance. The greater positive water balance does not appear to be detrimental.
为确定术中输注白蛋白对血液使用、水平衡及术后临床病程的影响，我们研究了两组成年心脏手术患者。第一组（30例患者）在体外循环（CPB）前抽取2单位血液时输注25克白蛋白，并在氧合器预充液中加入50克白蛋白。第二组（32例患者）在CPB结束前未输注白蛋白。两组临床病程无差异，血液使用量也无显著差异。第一组患者从抽血时到手术结束术中血细胞比容值较低。冠状动脉搭桥手术比心脏瓣膜手术的水平衡正值更大。接受冠状动脉搭桥术的患者中有43%的水平衡正值大于5升，而接受瓣膜手术的患者中有50%的水平衡小于3升。我们得出结论，在这些情况下不使用白蛋白的主要影响是增加净水平衡正值。更大的水平衡正值似乎并无损害。
