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Liver cirrhosis and nephrotic syndrome
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| bet | 37/654 | | Sana | 03.01.2022 | | Hajmi | 1,5 Mb. | | #14803 |
Liver cirrhosis and nephrotic syndrome: Hypoalbuminemia, oedema and ascites may be manifestation of liver cirrhosis and nephrotic syndrome [13]. Liver disorders: No studies have reported on the use of albumin infusion therapy in neonates with liver disorders. Infusions of albumin has been used in infants and children undergoing high volume paracentesis with a reported lower incidence of post-paracentesis circulatory dysfunction and asymptomatic hyponatremia but no difference in other clinical outcome [14]. However, as a fluid extraction of <200 mL/kg at a slow rate was associated with better haemodynamic stability, albumin infusion is not recommended [13, 14]. Nephrotic syndrome: In infants with congenital nephrotic syndrome and massive oedema, treatment with intravenous albumin and diuretic infusions has been used. However, the treatment has a risk of respiratory failure and congestive heart failure, so use of albumin infusion is cautioned [13].
Safety
There are insufficient data from RCTs in newborn infants to determine the safety of albumin infusion for any indication, although no adverse events attributable to albumin infusion were reported in trials in newborn infants [5, 9, 15]. Human albumin contains no preservatives and undergoes a rigorous pasteurisation process to ensure pathogen inactivation. It does not contain isoagglutinins or blood group substances; hence the risk of minor or major incompatibility is impossible. Additionally, hypersensitivity reactions such as flushing, urticaria, fever and nausea rarely occur following its administration, since albumin preparations are considered non-immunogenic [13]. However, possible harms associated with albumin infusion in neonates include fluid overload (pulmonary oedema, impaired gas exchange, worsening oxygenation, chronic lung disease, patent ductus arteriosus, myocardial dysfunction especially for infants with birth asphyxia), neurological injury (cerebral oedema, intraventricular haemorrhage due to rapid bolus administration), salt loading and fluid retention, and higher cost compared with crystalloids [13].
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