Premium
Changes in cardiac output and incidence of volume overload in cirrhotics receiving 20% albumin infusion
Author(s) -
Shasthry Saggere M.,
Kumar Manoj,
Khumuckham Jelen S.,
Sarin Shiv Kumar
Publication year - 2017
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13375
Subject(s) - volume overload , medicine , albumin , cirrhosis , cardiology , cardiac output , diastole , hemodynamics , anesthesia , heart failure , blood pressure
Background & Aims Patients with cirrhosis are prone to develop volume over load, have increased capillary permeability and latent or overt cardiomyopathy. Whether albumin infusion causes volume overload in cirrhotics has not been adequately studied. Methods Ninety nine consecutive cirrhotic patients receiving 1gm per kg albumin infusion were evaluated for development of volume overload. Clinical, echocardiographic and haemodynamic changes were closely monitored during and after albumin infusion. Results Thirty (30.30%) patients developed volume overload. Patients with higher BMI ( P =.003), lower CTP ( P =.01) and MELD ( P =.034) were more often associated with the development of volume overload. Though baseline diastolic dysfunction was present in 82.8% of the patients, it did not influence the development of volume overload or changes in the cardiac output. The cardiac output increased significantly after albumin infusion (4.9±1.554 L/min to 5.86±1.85 L/min, P <.001) irrespective of the development of volume overload, or the presence of diastolic dysfunction or the Child's status. Conclusion Nearly, one‐third of cirrhotics receiving standard albumin infusion develop volume overload, specially, those with higher BMI and lower severity of liver disease. Cardiac output increases after albumin infusion, and, baseline diastolic dysfunction has little effect on the development of volume overload or changes in cardiac output.