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Albumin administration in patients with cirrhosis: Current role and novel perspectives
Mortality in cirrhosis is mostly associated with the development of clinical decompensation, characterized by ascites, hepatic encephalopathy, variceal bleeding, or jaundice. Therefore, it is important to prevent and manage such complications. Traditionally, the pathophysiology of decompensated cirr...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9476855/ https://www.ncbi.nlm.nih.gov/pubmed/36156923 http://dx.doi.org/10.3748/wjg.v28.i33.4773 |
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author | de Mattos, Ângelo Zambam Simonetto, Douglas Alano Terra, Carlos Farias, Alberto Queiroz Bittencourt, Paulo Lisboa Pase, Tales Henrique Soares Toazza, Marlon Rubini de Mattos, Angelo Alves |
author_facet | de Mattos, Ângelo Zambam Simonetto, Douglas Alano Terra, Carlos Farias, Alberto Queiroz Bittencourt, Paulo Lisboa Pase, Tales Henrique Soares Toazza, Marlon Rubini de Mattos, Angelo Alves |
author_sort | de Mattos, Ângelo Zambam |
collection | PubMed |
description | Mortality in cirrhosis is mostly associated with the development of clinical decompensation, characterized by ascites, hepatic encephalopathy, variceal bleeding, or jaundice. Therefore, it is important to prevent and manage such complications. Traditionally, the pathophysiology of decompensated cirrhosis was explained by the peripheral arterial vasodilation hypothesis, but it is currently understood that decompensation might also be driven by a systemic inflammatory state (the systemic inflammation hypothesis). Considering its oncotic and nononcotic properties, albumin has been thoroughly evaluated in the prevention and management of several of these decompensating events. There are formal evidence-based recommendations from international medical societies proposing that albumin be administered in individuals with cirrhosis undergoing large-volume paracentesis, patients with spontaneous bacterial peritonitis, those with acute kidney injury (even before the etiological diagnosis), and those with hepatorenal syndrome. Moreover, there are a few randomized controlled trials and meta-analyses suggesting a possible role for albumin infusion in patients with cirrhosis and ascites (long-term albumin administration), individuals with hepatic encephalopathy, and those with acute-on-chronic liver failure undergoing modest-volume paracentesis. Further studies are necessary to elucidate whether albumin administration also benefits patients with cirrhosis and other complications, such as individuals with extraperitoneal infections, those hospitalized with decompensated cirrhosis and hypoalbuminemia, and patients with hyponatremia. |
format | Online Article Text |
id | pubmed-9476855 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-94768552022-09-23 Albumin administration in patients with cirrhosis: Current role and novel perspectives de Mattos, Ângelo Zambam Simonetto, Douglas Alano Terra, Carlos Farias, Alberto Queiroz Bittencourt, Paulo Lisboa Pase, Tales Henrique Soares Toazza, Marlon Rubini de Mattos, Angelo Alves World J Gastroenterol Minireviews Mortality in cirrhosis is mostly associated with the development of clinical decompensation, characterized by ascites, hepatic encephalopathy, variceal bleeding, or jaundice. Therefore, it is important to prevent and manage such complications. Traditionally, the pathophysiology of decompensated cirrhosis was explained by the peripheral arterial vasodilation hypothesis, but it is currently understood that decompensation might also be driven by a systemic inflammatory state (the systemic inflammation hypothesis). Considering its oncotic and nononcotic properties, albumin has been thoroughly evaluated in the prevention and management of several of these decompensating events. There are formal evidence-based recommendations from international medical societies proposing that albumin be administered in individuals with cirrhosis undergoing large-volume paracentesis, patients with spontaneous bacterial peritonitis, those with acute kidney injury (even before the etiological diagnosis), and those with hepatorenal syndrome. Moreover, there are a few randomized controlled trials and meta-analyses suggesting a possible role for albumin infusion in patients with cirrhosis and ascites (long-term albumin administration), individuals with hepatic encephalopathy, and those with acute-on-chronic liver failure undergoing modest-volume paracentesis. Further studies are necessary to elucidate whether albumin administration also benefits patients with cirrhosis and other complications, such as individuals with extraperitoneal infections, those hospitalized with decompensated cirrhosis and hypoalbuminemia, and patients with hyponatremia. Baishideng Publishing Group Inc 2022-09-07 2022-09-07 /pmc/articles/PMC9476855/ /pubmed/36156923 http://dx.doi.org/10.3748/wjg.v28.i33.4773 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/ |
spellingShingle | Minireviews de Mattos, Ângelo Zambam Simonetto, Douglas Alano Terra, Carlos Farias, Alberto Queiroz Bittencourt, Paulo Lisboa Pase, Tales Henrique Soares Toazza, Marlon Rubini de Mattos, Angelo Alves Albumin administration in patients with cirrhosis: Current role and novel perspectives |
title | Albumin administration in patients with cirrhosis: Current role and novel perspectives |
title_full | Albumin administration in patients with cirrhosis: Current role and novel perspectives |
title_fullStr | Albumin administration in patients with cirrhosis: Current role and novel perspectives |
title_full_unstemmed | Albumin administration in patients with cirrhosis: Current role and novel perspectives |
title_short | Albumin administration in patients with cirrhosis: Current role and novel perspectives |
title_sort | albumin administration in patients with cirrhosis: current role and novel perspectives |
topic | Minireviews |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9476855/ https://www.ncbi.nlm.nih.gov/pubmed/36156923 http://dx.doi.org/10.3748/wjg.v28.i33.4773 |
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