Comparison of the Effects of Albumin 5% versus Ringer's Lactate on Blood Loss and Coagulation after Vascular Surgery Using Thromboelastography

Ahmed Abdalla Mohamed; Nadia Gameel Elsharkawi; Osama Ismail Zaid; Ahmed Farag Mohamed; Nashwa Nabeel Mohamed; Michael Wahib Wadeed; Adham Feteha Tawfik; Amr Abdelmonam Abdelaziz Mostafa Elkatatny

doi:10.3889/oamjms.2019.263

Authors

Ahmed Abdalla Mohamed Department of Anaesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt
Nadia Gameel Elsharkawi Department of Anaesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt
Osama Ismail Zaid Department of Anaesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt
Ahmed Farag Mohamed Department of Anaesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt
Nashwa Nabeel Mohamed Department of Anaesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt
Michael Wahib Wadeed Department of Anaesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt
Adham Feteha Tawfik Students' Hospital, Cairo University, Cairo, Egypt
Amr Abdelmonam Abdelaziz Mostafa Elkatatny Faculty of Medicine, Cairo University, Cairo, Egypt

DOI:

https://doi.org/10.3889/oamjms.2019.263

Keywords:

Albumin 5%, Ringer's lactate, Vascular surgery, Blood loss, Coagulation, Thromboelastography

Abstract

AIM: Comparing the effects of Albumin 5% versus Ringer's lactate on blood loss and coagulation after vascular surgery using

METHODS: In this randomised study, 60 patients, aged (18-60 years) ASA physical status (I-III) undergoing vascular surgery were included in the study and randomly allocated into two groups using a random number generator, to receive either Human albumin or Ringer lactate after obtaining written informed consent. Group A received 1-2 ml per minute of human albumin 5% combined with normal saline (0.9%). Group B received Ringer's lactate only as of the main solution. Variables were measured after administration of fluids as postoperative measures. The amount of blood needed for testing was 4 ml drawn before the operation and at the end of surgery with a citrate tube (blue tube) from the venous line or using a regular needle. The standard time of 15 minutes was considered to begin processing.

RESULTS: There was no statistically significant difference observed between both groups regarding demographic data, surgical wound drainage, haemoglobin level, hematocrit level and coagulation profile. Regarding ROTEM thermoelectrometry variables showed that there was no statistically significant difference was found between the two groups In-TEM variables (Ex-TEM Clotting time, TEM Clot Formation Time) but In-TEM Alpha Angel measured in degrees showed a Statistically significant difference between the two groups. P < 0.001 and Ex-TEM Maximum Clotting Firmness MCF values measured in mm, there was a statistically significant difference between the two groups P = 0.045.

CONCLUSION: This study concluded that the use of human albumin (5%) in vascular surgeries before reaching the trigger point for blood transfusion didnâ€™t improve blood loss or coagulation profile compared to the use of ringer lactate only. Therefore, ringer lactate can be used as a good replacement for human albumin. Ringer lactate is readily available and inexpensive while human albumin may be costly.

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