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A comparison of albumin-bolus therapy versus normal saline-bolus therapy for hypotension in neonates

J Perinatol. 2007 Nov 8

Lynch SK, Mullett MD, Graeber JE, Polak MJ.

1Department of Pediatrics, Section of Neonatology, West Virginia University School of Medicine, Morgantown, WV, USA.

Objective:We compared responses to bolus infusion of 5% albumin (ALB) or normal saline (NS) for hypotension in neonates.Study Design:Hypotensive infants were given 10 ml kg(-1) of NS or ALB. A second bolus was given for persistent hypotension. Dopamine therapy was started for hypotension after the second bolus.


The primary response was increase in arterial blood pressure toward normal range 1 h postinfusion. Secondary measures included duration of normotension, meeting criteria for second bolus, meeting criteria for vasopressor support and cost comparison.Result:Those receiving ALB (N=49 ALB and 52 NS) were more likely to achieve a normotensive state (ALB=57.1%, NS=32.1% P=0.01) 1 h following the initial bolus therapy. Subsequently, the NS group was also more likely to qualify for vasopressor infusion (ALB=24.5%, NS=44.2% P=0.02). Overall cost for either therapy was equivalent.Conclusion:In hypotensive neonates, ALB results in a greater likelihood of achieving normotension and decreased subsequent use of vasopressors when compared to NS.Journal of Perinatology advance online publication, 8 November 2007; doi:10.1038/sj.jp.7211846.