Volume Kinetics for 20% Albumin in Different Clinical Situations

NCT ID: NCT02556580

Last Updated: 2018-03-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

45 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-02-29

Study Completion Date

2019-04-01

Brief Summary

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The study aims to determine the degree of plasma volume expansion and the half-life of the plasma volume expansion when 3 mL/kg of hyperoncotic (20%) albumin if infused over 30 minutes in conscious healthy volunteers, in patients undergoing surgery under general anesthesia, and on the day after major surgery when the patient is in a post surgical inflammatory state. The study also examines the increase in the plasma colloid osmotic pressure as a result of this infusion and its possible influence on markers of kidney damage.

Detailed Description

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15 volunteers, 15 patients undergoing surgery and 15 patients in the post-surgical phase will be recruited for this study because they have different degrees of vasodilatation and inflammation, which are factors of potential importance to the effectiveness of plasma volume expansion with albumin 20%. Hyperoncotic albumin should logically recruit fluid from the interstitial fluid space, but this possibility has recently been questioned in the "revised Starling equation".

The degree of plasma volume expansion and also the half-life will be estimated by population volume kinetics which uses serial analyses of the blood hemoglobin concentration and a summary measure of the excreted urine during the 5-hour experiment to calculate these outcome measures.

There is a risk that hyperoncotic solutions cause pre-renal anuria due to the rise in plasma oncotic pressure. As a safety measure we will assess the plasma oncotic pressure and relevant biomarkers of renal function during the experiments. The experiments will be ended with a slow infusion of 1 L of Ringer´s acetate to dilute any raised oncotic pressure.

Conditions

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Unconscious Inflammation

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Conscious healthy volunteers

Intervention: intravenious infusion Drug: albumin 20%

Group Type ACTIVE_COMPARATOR

Albumin 20%

Intervention Type DRUG

Intervention: intravenious infusion Drug: albumin

Surgery under general anesthesia

Intervention: intravenious infusion Drug: albumin 20%

Group Type EXPERIMENTAL

Albumin 20%

Intervention Type DRUG

Intervention: intravenious infusion Drug: albumin

Post-surgical inflammation

Intervention: intravenious infusion Drug: albumin 20%

Group Type EXPERIMENTAL

Albumin 20%

Intervention Type DRUG

Intervention: intravenious infusion Drug: albumin

Interventions

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Albumin 20%

Intervention: intravenious infusion Drug: albumin

Intervention Type DRUG

Other Intervention Names

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Albumin in healthy volunteers

Eligibility Criteria

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Inclusion Criteria

* Healthy volunteers.
* Patients in ASA classes I-II scheduled for surgery.

Exclusion Criteria

* Expected major hemorrhage during surgery.
* Blood hemoglobin concentration of \< 10 g/dL.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University Hospital, Linkoeping

OTHER

Sponsor Role collaborator

Karolinska University Hospital

OTHER

Sponsor Role collaborator

Sodertalje Hospital

OTHER

Sponsor Role lead

Responsible Party

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Robert Hahn

Research Dircetor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Robert G Hahn, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Research Director, Södertälje sjukhus

Locations

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Linköping University Hospital

Linköping, , Sweden

Site Status RECRUITING

Karolinska University Hospital

Stockholm, , Sweden

Site Status COMPLETED

Countries

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Sweden

Central Contacts

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Robert G Hahn, MD, PhD

Role: CONTACT

0046 8 55024000 ext. 4670

Joachim Zdolsek, MD, PhD

Role: CONTACT

00456 70 3031434

Facility Contacts

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Joachim Zdolsek, MD, PhD

Role: primary

0046 70 3031434

References

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Hedin A, Hahn RG. Volume expansion and plasma protein clearance during intravenous infusion of 5% albumin and autologous plasma. Clin Sci (Lond). 2005 Mar;108(3):217-24. doi: 10.1042/CS20040303.

Reference Type BACKGROUND
PMID: 15538944 (View on PubMed)

Woodcock TM, Woodcock TE. Revised Starling equation predicts pulmonary edema formation during fluid loading in the critically ill with presumed hypovolemia. Crit Care Med. 2012 Sep;40(9):2741-2; author reply 2742. doi: 10.1097/CCM.0b013e31825ae6c9. No abstract available.

Reference Type BACKGROUND
PMID: 22903119 (View on PubMed)

Wiedermann CJ, Dunzendorfer S, Gaioni LU, Zaraca F, Joannidis M. Hyperoncotic colloids and acute kidney injury: a meta-analysis of randomized trials. Crit Care. 2010;14(5):R191. doi: 10.1186/cc9308. Epub 2010 Oct 28.

Reference Type BACKGROUND
PMID: 21029460 (View on PubMed)

Gunnstrom M, Zdolsek JH, Hahn RG. Plasma Volume Expansion and Fluid Kinetics of 20% Albumin During General Anesthesia and Surgery Lasting for More Than 5 Hours. Anesth Analg. 2022 Jun 1;134(6):1270-1279. doi: 10.1213/ANE.0000000000005802. Epub 2021 Nov 18.

Reference Type DERIVED
PMID: 34797221 (View on PubMed)

Other Identifiers

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Albumin April 2015

Identifier Type: -

Identifier Source: org_study_id

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