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A comparison of albumin-bolus therapy versus normal saline-bolus therapy for hypotension in neonates |
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A comparison of albumin-bolus therapy versus normal saline-bolus therapy for hypotension in neonates.
J Perinatol. 2007 Nov 8
Lynch SK, Mullett MD, Graeber JE, Polak MJ.
1Department of Pediatrics, Section of Neonatology, West Virginia University School of Medicine, Morgantown, WV, USA.
Objective:We
compared responses to bolus infusion of 5% albumin (ALB) or normal
saline (NS) for hypotension in neonates.Study Design:Hypotensive
infants were given 10 ml kg(-1) of NS or ALB. A second bolus was given
for persistent hypotension. Dopamine therapy was started for
hypotension after the second bolus.
The primary response was increase
in arterial blood pressure toward normal range 1 h postinfusion.
Secondary measures included duration of normotension, meeting criteria
for second bolus, meeting criteria for vasopressor support and cost
comparison.Result:Those receiving ALB (N=49 ALB and 52 NS) were more
likely to achieve a normotensive state (ALB=57.1%, NS=32.1% P=0.01) 1 h
following the initial bolus therapy. Subsequently, the NS group was
also more likely to qualify for vasopressor infusion (ALB=24.5%,
NS=44.2% P=0.02). Overall cost for either therapy was
equivalent.Conclusion:In hypotensive neonates, ALB results in a greater
likelihood of achieving normotension and decreased subsequent use of
vasopressors when compared to NS.Journal of Perinatology advance online
publication, 8 November 2007; doi:10.1038/sj.jp.7211846.
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