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Changes in acid-base balance following bolus infusion of 20% albumin solution in humans

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Abstract

Objective

To evaluate changes in acid-base balance following bolus infusions of a 20% albumin solution.

Design and setting

Randomized prospective study in a university hospital.

Patients and participants

Two groups of eight patients each undergoing gynecological surgery.

Interventions

Patients were randomly assigned to receive either 0.9% saline or lactated Ringer’s solution. At the end of surgery two boluses of 0.5 g/kg body weight of a 20% albumin solution were administered. Arterial blood gases, electrolytes, and total protein were measured. The strong ion difference and the amount of weak plasma acid were calculated. pH and titratable acidity of the 20% albumin solution were determined.

Measurements and results

The infusion of a 20% albumin solution resulted in a significant decrease in pH from 7.284 to 7.262 in the saline group and from 7.422 to 7.394 in the Ringer’s group. In both groups the 20% albumin solution caused an increase in strong ion difference and an increase in the amount of weak plasma acid. The observed changes in serum bicarbonate concentration were in good agreement with the changes in strong ion difference and the amount of weak plasma acid. The 20% albumin solution possessed a pH of 6.95 and a titratable acidity of 85 mEq/l.

Conclusions

According to the Stewart approach, the observed changes in acid-base balance are the net result of the two opposing effects of the strong ion difference and the amount of weak plasma acid. Alternatively, the acidifying effect of the 20% albumin solution may stem from the titratable acid content of the solution.

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Authors and Affiliations

  1. Clinic of Anesthesiology, Ludwig-Maximilians-University, Marchioninistrasse 15, 81377, Munich, Germany

    Dirk Bruegger, Matthias Jacob, Peter Conzen, Udilo Finsterer & Markus Rehm

  2. Department of Physiology, Ludwig-Maximilians-University, Schillerstrasse 44, 80336, Munich, Germany

    Dirk Bruegger, Matthias Jacob & Bernhard F. Becker

  3. Department of Surgery, University of Homburg, Homburg, Germany

    Stefan Scheingraber

Authors
  1. Dirk Bruegger
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  2. Matthias Jacob
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  3. Stefan Scheingraber
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  4. Peter Conzen
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  5. Bernhard F. Becker
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  6. Udilo Finsterer
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  7. Markus Rehm
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Corresponding author

Correspondence to Matthias Jacob.

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Bruegger, D., Jacob, M., Scheingraber, S. et al. Changes in acid-base balance following bolus infusion of 20% albumin solution in humans. Intensive Care Med 31, 1123–1127 (2005). https://doi.org/10.1007/s00134-005-2683-4

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  • DOI: https://doi.org/10.1007/s00134-005-2683-4

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