Radha

Albumin Helps Low Blood Volume?

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does anyone know of good articles or info supporting the use of albumin in improving low blood volume? i was thinking of trying this, but trying to convince my doc to try it will be very very hard!! does anyone know if getting allbumin is risky and can you get it done at home? with just a nurse's help? i tried epogen while back and it didnt help at all, is it worth another try?? even after trying for 3 months?? thanks

radha

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Back when I worked at a veterinary journal, I edited a series of articles on fluid therapy for dogs and cats. The articles explained that if a dog or cat had lost a lot of blood, you could expand the blood volume for a short time by giving a "crystalloid" solution intravenously (i.e., a salt solution like saline or lactated Ringer's). However, the kidneys would notice that the blood was dilute and the excess salt and water would be lost in the urine in a short time. In order to keep the blood volume expanded, you had to give the poor beastie a "colloid" solution intravenously. Colloids are partway between a solution and a suspension, in terms of the size of the dispersed particles. In other words, the molecules in the colloid are big, too big to get lost through the kidneys. So they stay inside the blood vessels (holding water molecules in there, too) until you break them down. In normal blood plasma, albumin is the main protein in blood plasma and is responsible for about 70% of the colloid osmotic pressure (the force holding the water inside your blood vessels).

There are several types of "colloid" fluid that are given to expand blood volume in people who have lost blood because of bleeding. The most familiar, of course, is whole blood. But you can also give blood plasma, which is the fluid portion of the blood, minus the red blood cells. Blood plasma has all sorts of useful components, such as clotting factors, that are important for people who have lost blood because of an injury or who have a clotting disorder (e.g., a hereditary disorder like hemophilia or an acquired disorder like an infectious or autoimmune problem that consumes clotting factors). Then there are protein preparations, such as albumin. I don't know if they use albumin from cattle for human resuscitation anymore, because of the concerns about mad cow disease. The other kinds of colloids are complex carbohydrates (dextran, hetastarch).

There are several things to consider when choosing which colloid to use. First of all, blood and blood components are somewhat scarce, because they are donated by human volunteers. So they are generally reserved for very serious cases. Another concern is that you want to avoid introducing foreign proteins (either from other people or from animals) into your bloodstream unless it is absolutely necessary. At present, the blood supply is safe from HIV in most places, but there is the theoretical risk of the transmission of other infective agents, such as the prions responsible for mad cow disease in cattle and variant Creutzfeldt-Jakob disease in humans. Also, you just don't need to challenge your immune system by exposing it to foreign proteins unnecessarily. The other option, of course, are the complex carbohydrates. I had asked one of my doctors for hetastarch after he found that I had horribly low blood volume. I think he thought I was joking. I would gladly volunteer for a study in which hetastarch is used to expand blood volume in POTS. I'm not kidding.

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thanks so much for your detailed reply, can a family member donate the whole blood to give me the plasma part? and do you have to have a low albumin blood level to qualify getting albumin infusions , or can you just have low blood volume? thanks again for all the info,

radha

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I don't know. Has your blood volume been measured? If the plasma volume is low, have you tried increasing your salt and water intake and drinking licorice tea? Have you tried fludrocortisone (Florinef)? If your red cell mass is low, have you tried taking extra iron supplements and extra B vitamins? Have you had B vitamin shots? Those are the cheap and easy things.

The next step, of course, is Epogen, which doesn't seem to have helped you. Did it increase your red cell mass at all? When I tried it, it increased my red cell mass but my plasma volume went down even further.

I don't know how one would go about getting albumin. Some people have enough trouble as it is getting saline! I don't know if there is a risk of a reaction to albumin. I don't know if they can give that to you at home.

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i do have low blood volume, was tested, but not anemic and have tried tons of water and salt and did try epogen which didnt do anything at all for me, i havent tried florinef coz i already get terrible headaches and am hyper most of the time, so i was thinking about albumin, but getting my doc to agree to it is another story and i was wondering do you have to have a low albumin blood level or just low total blood volume to be able to get the injections? and does anyone have emma's email address on the dinet newsletter? thanks for any help, i dont have anyone to give me the answers to these questions,

radha

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When you say that you are not anemic, does that mean that your total red cell mass is normal? Some doctors think that normal hematocrit means that you aren't anemic. But if you have a plasma deficit and a normal hematocrit, then you have a decreased red cell mass, which by definition means that you are anemic.

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sorry i am not sure about the red cell mass, but the epogen didnt help me to feel any better, would it be worth trying again or if didnt help once, then it will not ever help me?? i tried it a couple of years ago, anyone know anything about my questions about albumin?? thanks for your replies

radha

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Hi I know this is an old thread but currently relevant to me and I'd like to revive it and hear about anybody's more recent experiences with albumin or other colloids instead of or compared to saline!

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About 2 Years ago I was in ICU because my blood pressure just wouldn't come up. (They had me upside down and my bp still wouldn't go any higher than 70/40.) They had me on dopamine and neosynephrine without good enough results so The ICU Dr put me on albumin and within a couple hours I was stable and moved to the cardiac floor. He wasn't sure it would work but it sure did! The first thing they did in the ER was fluids, have me 3.5 liters with no change.

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On 12/5/2017 at 6:21 PM, ANCY said:

About 2 Years ago I was in ICU because my blood pressure just wouldn't come up. (They had me upside down and my bp still wouldn't go any higher than 70/40.) They had me on dopamine and neosynephrine without good enough results so The ICU Dr put me on albumin and within a couple hours I was stable and moved to the cardiac floor. He wasn't sure it would work but it sure did! The first thing they did in the ER was fluids, have me 3.5 liters with no change.

Wow, Albumin really worked a treat for you! I would love to try it even intermittently as most of a bag of saline escapes from the vasculature very quickly (not that I am anywhere close to getting any form of IV fluids though the medial system at this point)!

Have you ever been able to obtain it on a more regular basis since, given it helped so much?

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No, the ICU dr was the one who ordered it and I had a horrible experience with the attending cardiologist during that hospital stay and he certainly wasn't going to write for anything... I hadn't given much though to having it outpatient, I may bring it up with my cardiologist. Currently getting iv fluids twice a week and they are helping so not sure he'd want to add another thing. 

Please update of you figure something out and if it works? 

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