Human albumin in extracorporeal prime: effect on platelet function and bleeding

Area of Science:

• Cardiovascular Surgery
• Biomaterials Science
• Hematology

Background:

• Synthetic starches are used as albumin substitutes in extracorporeal circuits for osmotic and oncotic pressure.
• Albumin also passivates synthetic surfaces by forming a protein monolayer.
• The clinical benefit of this albumin-induced biopassivation is not well-established.

Purpose of the Study:

• To evaluate the effect of human albumin in the extracorporeal prime on platelet count, platelet function, and bleeding rates.
• To determine if protein biopassivation of the extracorporeal circuit offers patient benefits.

Main Methods:

• A randomized study of 20 patients undergoing coronary artery bypass surgery.
• The study group received human albumin in the extracorporeal prime, while the control group did not.
• Platelet count, platelet function, and 24-hour chest tube drainage were monitored.

Main Results:

• Platelet count was significantly higher during bypass in the albumin group (p<0.05).
• No significant differences in platelet function were observed between groups.
• 24-hour chest tube drainage was significantly lower in the albumin group (p<0.05).

Conclusions:

• Human albumin passivates extracorporeal circuit surfaces, potentially preserving platelet counts and reducing bleeding.
• While statistically significant benefits were noted, the overall clinical significance of albumin biopassivation may be limited.