Yin J, Sun M, Zeng Y, Cai M, Liu H, Jin Y. Safety and Efficacy of Albumin for Pump Priming in Cardiac Surgery: A Meta-Analysis.
J Cardiothorac Vasc Anesth 2024;
38:517-525. [PMID:
37932194 DOI:
10.1053/j.jvca.2023.10.008]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/03/2023] [Accepted: 10/04/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVES
To assess the efficacy and safety of albumin as pump priming fluid in cardiac surgery.
DESIGN
Meta-analysis of randomized controlled trials.
SETTING
Each study was conducted in a surgical center or intensive care unit.
PARTICIPANTS
Adult and pediatric patients undergoing cardiac surgery with cardiopulmonary bypass who received circuit priming fluids.
INTERVENTIONS
Extracorporeal circuit priming with either albumin or crystalloid.
MEASUREMENTS AND RESULTS
Fourteen eligible randomized controlled trials with 741 patients were included in the present meta-analysis. Albumin prime had lower bleeding (CI -202.20 to -142.88 mL, p < 0.00001) and showed a greater advantage in preserving platelet counts (CI 14.85-21.48 × 103 mm-3, p < 0.00001), maintaining colloid osmotic pressure and sustaining negative fluid balance. No significant differences were found in the remaining study outcomes.
CONCLUSIONS
Albumin was shown to be safe and efficacious in extracorporeal circulation perfusion. However, its clinical advantages were not clearly highlighted, as there were no significant differences in the number of deaths, length of hospital stay, or intensive care unit duration. The results should be interpreted cautiously, as most included studies were small in scale, and the total number of participants was limited.
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