Is there still a need for albumin infusions to treat patients with liver disease?.

The course of patients with cirrhosis is frequently complicated by derangement of body fluid homeostasis which results in accumulation of large amounts of extracellular fluid in the peritoneal cavity and interstitial tissue.1 Investigations performed in the 1940s proposed that the formation of ascit...

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Detalles Bibliográficos
Autores: Ginès i Gibert, Pere, Arroyo, Vicente
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2000
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/18661
Acceso en línea:https://hdl.handle.net/2445/18661
Access Level:acceso abierto
Palabra clave:Malalties del fetge
Albúmines
Liver diseases
Albumins
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spelling Is there still a need for albumin infusions to treat patients with liver disease?.Ginès i Gibert, PereArroyo, VicenteMalalties del fetgeAlbúminesLiver diseasesAlbuminsThe course of patients with cirrhosis is frequently complicated by derangement of body fluid homeostasis which results in accumulation of large amounts of extracellular fluid in the peritoneal cavity and interstitial tissue.1 Investigations performed in the 1940s proposed that the formation of ascites and oedema was related to an imbalance in Starling's equilibrium in splanchnic and systemic capillaries caused by increased hydrostatic pressure due to portal hypertension and reduced oncotic pressure because of the low serum albumin levels characteristic of cirrhosis, which would favour the passage of fluid from the intravascular compartment to the interstitial tissue.2-4 Later studies showed that patients with cirrhosis and ascites have marked circulatory dysfunction, characterised mainly by low systemic vascular resistance and arterial pressure, abnormal distribution of blood volume, with reduced central blood volume, and marked stimulation of vasoconstrictor and antinatriuretic systems (that is, the renin-angiotensin-aldosterone system and sympathetic nervous system).5 6 In some patients this circulatory dysfunction is so intense that renal perfusion is greatly reduced leading to severe impairment of renal function, a condition known as hepatorenal syndrome.7Considering all of these factors it is not surprising that albumin infusions have been used for many years in the management of patients with cirrhosis and ascites in an attempt to reduce the formation of ascites and/or improve circulatory and renal function.8 In the current decade the use of albumin in cirrhosis has regained attention because of the demonstration that patients with large ascites can be treated safely with large volume paracentesis associated with albumin infusions.9 While some of these indications for albumin infusions are supported by the results of randomised studies, others are based on clinical experience and have not been proved in prospective investigations. Therefore, the use of albumin infusions in patients with cirrhosis is controversial. Recently, …BMJ Group2000info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/18661Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció digital del document publicat a: http://dx.doi.org/10.1136/gut.46.5.588Gut, 2000, vol. 46, p. 588-590http://dx.doi.org/10.1136/gut.46.5.588(c) BMJ Publishing Group Ltd and British Society of Gastroenterology, 2000info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/186612026-05-27T06:46:51Z
dc.title.none.fl_str_mv Is there still a need for albumin infusions to treat patients with liver disease?.
title Is there still a need for albumin infusions to treat patients with liver disease?.
spellingShingle Is there still a need for albumin infusions to treat patients with liver disease?.
Ginès i Gibert, Pere
Malalties del fetge
Albúmines
Liver diseases
Albumins
title_short Is there still a need for albumin infusions to treat patients with liver disease?.
title_full Is there still a need for albumin infusions to treat patients with liver disease?.
title_fullStr Is there still a need for albumin infusions to treat patients with liver disease?.
title_full_unstemmed Is there still a need for albumin infusions to treat patients with liver disease?.
title_sort Is there still a need for albumin infusions to treat patients with liver disease?.
dc.creator.none.fl_str_mv Ginès i Gibert, Pere
Arroyo, Vicente
author Ginès i Gibert, Pere
author_facet Ginès i Gibert, Pere
Arroyo, Vicente
author_role author
author2 Arroyo, Vicente
author2_role author
dc.subject.none.fl_str_mv Malalties del fetge
Albúmines
Liver diseases
Albumins
topic Malalties del fetge
Albúmines
Liver diseases
Albumins
description The course of patients with cirrhosis is frequently complicated by derangement of body fluid homeostasis which results in accumulation of large amounts of extracellular fluid in the peritoneal cavity and interstitial tissue.1 Investigations performed in the 1940s proposed that the formation of ascites and oedema was related to an imbalance in Starling's equilibrium in splanchnic and systemic capillaries caused by increased hydrostatic pressure due to portal hypertension and reduced oncotic pressure because of the low serum albumin levels characteristic of cirrhosis, which would favour the passage of fluid from the intravascular compartment to the interstitial tissue.2-4 Later studies showed that patients with cirrhosis and ascites have marked circulatory dysfunction, characterised mainly by low systemic vascular resistance and arterial pressure, abnormal distribution of blood volume, with reduced central blood volume, and marked stimulation of vasoconstrictor and antinatriuretic systems (that is, the renin-angiotensin-aldosterone system and sympathetic nervous system).5 6 In some patients this circulatory dysfunction is so intense that renal perfusion is greatly reduced leading to severe impairment of renal function, a condition known as hepatorenal syndrome.7Considering all of these factors it is not surprising that albumin infusions have been used for many years in the management of patients with cirrhosis and ascites in an attempt to reduce the formation of ascites and/or improve circulatory and renal function.8 In the current decade the use of albumin in cirrhosis has regained attention because of the demonstration that patients with large ascites can be treated safely with large volume paracentesis associated with albumin infusions.9 While some of these indications for albumin infusions are supported by the results of randomised studies, others are based on clinical experience and have not been proved in prospective investigations. Therefore, the use of albumin infusions in patients with cirrhosis is controversial. Recently, …
publishDate 2000
dc.date.none.fl_str_mv 2000
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/18661
url https://hdl.handle.net/2445/18661
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció digital del document publicat a: http://dx.doi.org/10.1136/gut.46.5.588
Gut, 2000, vol. 46, p. 588-590
http://dx.doi.org/10.1136/gut.46.5.588
dc.rights.none.fl_str_mv (c) BMJ Publishing Group Ltd and British Society of Gastroenterology, 2000
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) BMJ Publishing Group Ltd and British Society of Gastroenterology, 2000
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv BMJ Group
publisher.none.fl_str_mv BMJ Group
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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