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Background <p>The rationale of albumin use lies in its potential to increase oncotic pressure and optimize tissue perfusion. Randomized trials have not demonstrated a survival benefit, and the effects of albumin on volemia remain unclear. This study investigates, in healthy pigs, the effects of a 48-h albumin infusion on intravascular fluid volume, albumin kinetics, and its impact on respiratory function.</p> Methods <p>Thirty-nine healthy female pigs ventilated for 48&#xa0;h were grouped according to mechanical power (high ~ 18&#xa0;J/min vs. low ~ 6&#xa0;J/min) and type of fluid (5% albumin solution vs. crystalloid), generating four experimental groups: MP<sub>LOW</sub>-Crystalloid; MP<sub>LOW</sub>-Albumin; MP<sub>HIGH</sub>-Crystalloid; and MP<sub>HIGH</sub>-Albumin.</p> Results <p>Intravascular fluid volume was similar across groups (MP<sub>LOW</sub>-Crystalloid: 1.92 (± 0.38)L; MP<sub>HIGH</sub>-Crystalloid: 1.72 (± 0.40)L; MP<sub>LOW</sub>-Albumin: 1.86 (± 0.37)L; MP<sub>HIGH</sub>-Albumin: 2.10 (± 0.58)L; <i>p</i> 0.389). For the same mechanical power, the fraction of albumin lost from the plasma was higher in the albumin compared to the crystalloid groups (MP<sub>LOW</sub>-Albumin: 62 (± 13)% vs. MP<sub>LOW</sub>-Crystalloid: −&#xa0;16 (± 66)%; and MP<sub>HIGH</sub>-Albumin: 58 (± 24)% vs. MP<sub>HIGH</sub>-Crystalloid: 29 (± 14)%; <i>p </i>&lt; 0.001). Albumin groups showed greater ascites (MP<sub>LOW</sub>-Crystalloid: 261 (± 380)mL; MP<sub>HIGH</sub>-Crystalloid: 144 (± 148)mL; MP<sub>LOW</sub>-Albumin: 710 (± 664)mL; MP<sub>HIGH</sub>-Albumin: 685 (± 651)mL; <i>p</i> 0.034), and worse end-expiratory lung gas volume and elastance, despite comparable histological damage.</p> Conclusions <p>In our cohort, prolonged albumin infusion did not lead to a difference in intravascular fluid volume, but it resulted in the loss of ~ 60% of the infused albumin and ascites development. Ascites was associated with lower end-expiratory lung gas volume and higher elastance, despite similar histological lung damage across the groups.</p>

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Albumin kinetics, intravascular fluid volume, and respiratory function in pigs ventilated at different levels of mechanical power following crystalloid vs. albumin infusion

  • 期刊论文

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  • 发表日期：

    2026年2月5日

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  • Simone Gattarello,
  • Gaetano Gazzé,
  • Emanuele Rollo,
  • Beatrice Donati,
  • Martina Caronna,
  • Ilaria Grava,
  • Carlo Chiumiento,
  • Zhe Li,
  • Walter Gallese,
  • Domenico Nocera,
  • Stefano Giovanazzi,
  • Aurelio Sonzogni,
  • Chiara Sonzogni,
  • Alessandro Gatta,
  • Francesca Collino,
  • Luigi Camporota,
  • Michael Quintel,
  • Onnen Moerer,
  • Federica Romitti,
  • Luciano Gattinoni,
  • Mattia Busana

摘要

Background

The rationale of albumin use lies in its potential to increase oncotic pressure and optimize tissue perfusion. Randomized trials have not demonstrated a survival benefit, and the effects of albumin on volemia remain unclear. This study investigates, in healthy pigs, the effects of a 48-h albumin infusion on intravascular fluid volume, albumin kinetics, and its impact on respiratory function.

Methods

Thirty-nine healthy female pigs ventilated for 48 h were grouped according to mechanical power (high ~ 18 J/min vs. low ~ 6 J/min) and type of fluid (5% albumin solution vs. crystalloid), generating four experimental groups: MPLOW-Crystalloid; MPLOW-Albumin; MPHIGH-Crystalloid; and MPHIGH-Albumin.

Results

Intravascular fluid volume was similar across groups (MPLOW-Crystalloid: 1.92 (± 0.38)L; MPHIGH-Crystalloid: 1.72 (± 0.40)L; MPLOW-Albumin: 1.86 (± 0.37)L; MPHIGH-Albumin: 2.10 (± 0.58)L; p 0.389). For the same mechanical power, the fraction of albumin lost from the plasma was higher in the albumin compared to the crystalloid groups (MPLOW-Albumin: 62 (± 13)% vs. MPLOW-Crystalloid: − 16 (± 66)%; and MPHIGH-Albumin: 58 (± 24)% vs. MPHIGH-Crystalloid: 29 (± 14)%; p < 0.001). Albumin groups showed greater ascites (MPLOW-Crystalloid: 261 (± 380)mL; MPHIGH-Crystalloid: 144 (± 148)mL; MPLOW-Albumin: 710 (± 664)mL; MPHIGH-Albumin: 685 (± 651)mL; p 0.034), and worse end-expiratory lung gas volume and elastance, despite comparable histological damage.

Conclusions

In our cohort, prolonged albumin infusion did not lead to a difference in intravascular fluid volume, but it resulted in the loss of ~ 60% of the infused albumin and ascites development. Ascites was associated with lower end-expiratory lung gas volume and higher elastance, despite similar histological lung damage across the groups.