PULMONARY ARTERIAL AND RIGHT-VENTRICULAR RESPONSES TO PROPHYLACTIC ALBUMIN ADMINISTRATION BEFORE AORTIC UNCLAMPING DURING ABDOMINAL AORTIC ANEURYSMECTOMY

During abdominal aortic aneurysmectomy (AAAectomy) and before aortic u nclamping (XU), we studied the effects of albumin administration on pu lmonary arterial and right ventricular responses in 39 anesthetized pa tients using a modified thermodilution technique. Group 1 patients (n = 18) were given no extra IV fluids. Group 2 patients (n = 21) were gi ven additional albumin administration (5% albumin at 10 mL/kg) before XU. After XU, mean arterial blood pressure (MAP) decreased significant ly in each group, and MAT and stroke volume index (SVI) were not signi ficantly higher in Group 2 than in Group 1. At 5 min after XU, the pat ients in Group 2 had a higher mean pulmonary arterial pressure and pul monary vascular resistance index and a lower right ventricular ejectio n fraction than those in Group 1 (P < 0.05), but their SVIs were well maintained. These results indicate that albumin administration before XU may not always prevent post-XU hypotension. It caused a significant increase in right ventricular afterload and a significant dilation of the right ventricular cavity; however, right ventricular function was almost equally maintained in both groups. However, because SVI did no t increase in some patients (Group 2) with the increase in right ventr icular end-diastolic volume index after XU, albumin administration sho uld be performed carefully before XU during AAAectomy. Implications: W e studied the effects of albumin administration before aortic unclampi ng on pulmonary arterial and right ventricular responses during abdomi nal aortic aneurysmectomy using a modified thermodilution technique. A lbumin administration before aortic unclamping may not always prevent hypotension, and it may cause a higher pulmonary arterial pressure tha n in patients without albumin administration.