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- W4386983256 abstract "Objectives To study quantitative potency of plasma albumin on cardioprotection in terms of creatinine kinase-myocardial band mass (CK-MBm) in on-pump cardiac surgery. Design Post hoc analysis of a double-blinded randomized clinical trial. Setting Single center study in Helsinki University Hospital. Participants 1386 adult on-pump cardiac surgical patients. Intervention 4% albumin (n=693) or Ringer acetate (n=693) administration for cardiopulmonary bypass priming and volume replacement intraoperatively and postoperatively during the first 24 hours. Measurements and main results We measured albumin concentration preoperatively and intraoperatively (after protamine administration), and CK-MBm on the first postoperative morning. We performed multivariate linear regression analyses in the whole cohort and the Ringer group. Plasma albumin concentration did not differ between the groups preoperatively (Ringer vs. albumin: 38.3±5.0 g/L vs. 38.6±4.5 g/L, p=0.171), but differed intraoperatively (29.5±5.2 g/L vs. 41.5±6.0 g/L, p<0.001). CK-MBm was higher in the Ringer (32.0±34.8 μg/L) than the albumin group (24.3±33.0 μg/L, p<0.001). Aortic cross-clamping time associated with CK-MBm in the whole cohort [standardized β=0.376 (95% confidence interval 0.315-0.437), p<0.001] and the Ringer group [β=0.363 (0.273-0.452), p<0.001]. Albumin administration in the whole cohort [β=-0.156 (-0.201 – -0.111), p<0.001] and high intraoperative albumin concentration in the Ringer group [β=-0.07 (-0.140 – -0.003), p=0.04] associated with reduced CK-MBm. Compared to ischemia-induced increase in CK-MBm, albumin's potency to reduce CK-MBm was 41% in the whole cohort (β-value ratio of -0.156/0.376) and 19% in the Ringer group (β-value ratio of -0.07/0.363). Conclusion Both endogenous and exogenous albumin appear to be cardioprotective in terms of CK-MBm release in on-pump cardiac surgery." @default.
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- W4386983256 date "2023-09-01" @default.
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- W4386983256 title "Albumin and Cardioprotection in On-Pump Cardiac Surgery – A Post Hoc Analysis of a Randomized Trial" @default.
- W4386983256 doi "https://doi.org/10.1053/j.jvca.2023.09.028" @default.
- W4386983256 hasPublicationYear "2023" @default.
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