Abstract
Objective:
To compare the efficacy of albumin to normal saline (NS) for initial hydration therapy for dehydrated term infants with severe metabolic acidosis due to acute diarrhea.
Study Design:
We randomized 33 infants presenting with moderate-to-severe dehydration and metabolic acidosis (pH <7.25 or base excess (BE) <−15) into two groups, an albumin group (n=15) and a NS group (n=18). For initial hydration treatment, the albumin group received 5% albumin (10 ml kg−1), whereas the NS group received NS (10 ml kg−1).
Result:
After 3 h of treatment, both groups improved. However, the magnitude of improvement in the pH, BE and HCO3− levels were not different in comparisons between these two groups. In addition, there were no differences either in the body weight and weight gain 4 days after treatment or in the length of hospital stay.
Conclusion:
Albumin was not more effective than NS for initial hydration treatment of dehydrated term infants with metabolic acidosis due to acute diarrhea.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Doweiko JP, Nompleggi DJ . Role of albumin in human physiology and pathophysiology. JPEN J Parenter Enteral Nutr 1991; 15: 207–211.
Belgaumkar A, Greenough A, Kavvadia V, Dimitriou G . Metabolic acidosis: response to albumin infusion. Eur J Pediatr 1998; 157: 520–521.
Dimitriou G, Greenough A, Mantagos J, Skinner S . Metabolic acidosis, core-peripheral temperature difference and blood pressure response to albumin infusion in hypotensive, very premature infants. J Perinat Med 2001; 29: 442–445.
Dixon H, Hawkins K, Stephenson T . Comparison of albumin versus bicarbonate treatment for neonatal metabolic acidosis. Eur J Pediatr 1999; 158: 414–415.
Lawn CJ, Weir FJ, McGuire W . Base administration or fluid bolus for preventing morbidity and mortality in preterm infants with metabolic acidosis. Cochrane Database Syst Rev 2005; 2: CD003215.
Narchi H . Is an intravenous fluid bolus of albumin or normal saline beneficial in the treatment of metabolic acidosis in a normovolaemic newborn? Arch Dis Child 2004; 89: 884–885.
Kliegman RM, Behrman RE, Jenson HB, Stanton BF . Nelson textbook of pediatrics. WB Saunders CO: Philadelphia, 2007, pp 313.
Wilkes MM, Navickis RJ . Patient survival after human albumin administration. A meta-analysis of randomized, controlled trials. Ann Intern Med 2001; 135: 149–164.
Vincent JL, Wilkes MM, Navickis RJ . Safety of human albumin—serious adverse events reported worldwide in 1998–2000. Br J Anaesth 2003; 91: 625–630.
von Hoegen I, Waller C . Safety of human albumin based on spontaneously reported serious adverse events. Crit Care Med 2001; 29: 994–996.
Jardine LA, Jenkins-Manning S, Davies MW . Albumin infusion for low serum albumin in preterm newborn infants. Cochrane Database Syst Rev 2004; 3: CD004208.
Oca MJ, Nelson M, Donn SM . Randomized trial of normal saline versus 5% albumin for the treatment of neonatal hypotension. J Perinatol 2003; 23: 473–476.
So KW, Fok TF, Ng PC, Wong WW, Cheung KL . Randomised controlled trial of colloid or crystalloid in hypotensive preterm infants. Arch Dis Child Fetal Neonatal Ed 1997; 76: F43–F46.
Lynch SK, Mullett MD, Graeber JE, Polak MJ . A comparison of albumin-bolus therapy versus normal saline-bolus therapy for hypotension in neonates. J Perinatol 2008; 28: 29–33.
Greenough A, Emery E, Hird MF, Gamsu HR . Randomised controlled trial of albumin infusion in ill preterm infants. Eur J Pediatr 1993; 152: 157–159.
Kavvadia V, Greenough A, Dimitriou G, Hooper R . Randomised trial of fluid restriction in ventilated very low birthweight infants. Arch Dis Child Fetal Neonatal Ed 2000; 83: F91–F96.
Greenough A, Cheeseman P, Kavvadia V, Dimitriou G, Morton M . Colloid infusion in the perinatal period and abnormal neurodevelopmental outcome in very low birth weight infants. Eur J Pediatr 2002; 161: 319–323.
Jobe A, Jacobs H, Ikegami M, Berry D . Lung protein leaks in ventilated lambs: effects of gestational age. J Appl Physiol 1985; 58: 1246–1251.
Nitta K, Kobayashi T . Impairment of surfactant activity and ventilation by proteins in lung edema fluid. Respir Physiol 1994; 95: 43–51.
Seeger W, Gunther A, Walmrath HD, Grimminger F, Lasch HG . Alveolar surfactant and adult respiratory distress syndrome. Pathogenetic role and therapeutic prospects. Clin Investig 1993; 71: 177–190.
Maitland K, Pamba A, English M, Peshu N, Marsh K, Newton C et al. Randomized trial of volume expansion with albumin or saline in children with severe malaria: preliminary evidence of albumin benefit. Clin Infect Dis 2005; 40: 538–545.
Juca CA, Rey LC, Martins CV . Comparison between normal saline and a polyelectrolyte solution for fluid resuscitation in severely dehydrated infants with acute diarrhoea. Ann Trop Paediatr 2005; 25: 253–260.
Acknowledgements
This study was supported by a Korea University Grant and by the Hin Moe (Dr Hyun-Gum Lee) Research Foundation. We thank the physicians and nursing staff working in the neonatal intensive care unit and the pediatric general ward of Korea University Ansan Hospital for their enthusiastic support and cooperation.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Han, J., Yim, H., Lee, J. et al. Albumin versus normal saline for dehydrated term infants with metabolic acidosis due to acute diarrhea. J Perinatol 29, 444–447 (2009). https://doi.org/10.1038/jp.2008.244
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/jp.2008.244
Keywords
This article is cited by
-
Neonatal fluid overload—ignorance is no longer bliss
Pediatric Nephrology (2023)