Albumin administration in patients with cirrhosis: Current role and novel perspectives  

作　　者：Angelo Zambam de Mattos Douglas Alano Simonetto Carlos Terra Alberto Queiroz Farias Paulo Lisboa Bittencourt Tales Henrique Soares Pase Marlon Rubini Toazza Angelo Alves de Mattos Alliance of Brazilian Centers for Cirrhosis Care-the ABC Group 

机构地区：[1]Graduate Program in Medicine:Hepatology,Federal University of Health Sciences of Porto Alegre,Porto Alegre 90050-170,Brazil [2]Division of Gastroenterology and Hepatology,Mayo Clinic,Rochester,MN 55902,United States [3]Department of Gastroenterology,State University of Rio de Janeiro,Rio de Janeiro 20550-170,Brazil [4]Department of Gastroenterology,University of São Paulo,São Paulo 01246-903,Brazil [5]Gastroenterology and Hepatology Unit,Hospital Português,Salvador 40130-030,Brazil [6]Internal Medicine Unit,Irmandade Santa Casa de Misericórdia de Porto Alegre,Porto Alegre 90020-090,Brazil [7]Gastroenterology and Hepatology Unit,Irmandade Santa Casa de Misericórdia de Porto Alegre,Porto Alegre 90020-090,Brazil [8]不详

出　　处：《World Journal of Gastroenterology》2022年第33期4773-4786,共14页世界胃肠病学杂志（英文版）

摘　　要：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.

关 键 词：CIRRHOSIS ALBUMIN PARACENTESIS Spontaneous bacterial peritonitis Acute kidney injury Hepatorenal syndrome 

分 类 号：R575.2[医药卫生—消化系统]