The primary aim of this study is to assess the effect of hyperoncotic albumin on vascular hemodynamics and oxygen delivery after orthotopic liver transplant. The secondary aim is to try to identify the dominant physiological mechanism so that we will be able to better identify patients that may benefit from the use of albumin (25%) boluses in addition to standard care in patients following liver transplantation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
20
100 ml of saline will be given in addition to the standard of care every 8 hours for 24 hours.
100 ml of 25% albumin will be given in addition to the standard of care every 8 hours for 24 hours
Royal Victoria Hospital
Montreal, Quebec, Canada
Cardiac index (CI)
Time frame: 60 minutes after the infusion of the fluid
Cardiac function response
An improvement in Q due primarily to a change in cardiac function should have an increase in Q of ≥ 0.3 ml/min/m2/mmHg
Time frame: 30 and 60 minutes after the infusion of the fluid
A decrease in leak and plasma expansion
A decrease in leak and plasma expansion will be determined by the Harrison formula for calculating a change in plasma volume from the change in Hb and change in Hct
Time frame: 30 and 60 minutes after the infusion of the fluid
Cardiac output response
Cardiac output response primarily due to a "volume effect" would be expected to have an increase of CVP of a minimum of 2 mmHg and an increase in CI of \> 0.3 L/min/m2 per mmHg.
Time frame: 30 and 60 minutes after the infusion of the fluid
Detoxification effect of albumin
A increase in vascular tone will be identified by an increase in systemic vascular resistance or a rise in blood pressure without a change in cardiac output or a rise in blood pressure with a fall in cardiac output
Time frame: 30 and 60 minutes after infusion
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