The Effect And Clinical Therapeutic Observation Of Exogenous Albumin Infusion In Early ARDS Pulmonary Capillary Protein Leakage

Objective:To rearch the effect of exogenous albumin on serum albumin (ALB), C-reactive protein (CRP) and high mobility group protein 1 (HMGB1) on ARDS patients at acute stage; To investigate the relevance between plasma albumin levels and the severity of pulmonary capillary protein leakage; To observe the clinical effects of the early infusion of exogenous albumin in the treatment of acute ARDS.Methods:60 cases of acute ARDS patients were randomly divided into treatment group (T) and control group (C). On the first day after ARDS diagnosis, T group was given with 20 mg/d human albumin by intravenous infusion for 3 days, in addition to other treatment options also the same with C group. The serum ALB, CRP and HMGB-1 levels of 2 groups were tested before and after treatment by enzyme-linked immunosorbent assay (ELISA). On the third day after ARDS occurred, the bronchial-alveolar lavage fluid (BALF) sample was obtained; The level of ALB, CRP and HMGB-1 in BALF were tested by ELISA. Observed the parameter changes before and after treatment such as body temperature(T), respiratory rate(RR), oxygenation index (PaO2/FiO2); compared with the mechanical ventilation time, ICU hospitalization time and the mortality between 2 groups.Results:The T group serum ALB level significantly increased(30.37±2.29 vs 28.01±2.19), CRP and HMGB-1 level decreased (TCRP=149.15±30.96 vs CCRP=86.00±25.41;THMGB1=51.46±30.96 vs THMGB-1=45.38±11.13). To compare with C group, the difference was statistically significant (P<0.05). The parameter level of BALF in C group was significantly higher than the target T group(P<0.05). The serum ALB level and albumin level of lavage fluid was negatively correlated with correlation coefficient r=-0.701 (P<0.05), serum HMGB-1 had the highest correlation with pulmonary capillaries protein leakage r=0.900. The clinical parameters had remarkable improvement in treatment group (T=0.368±0.299;ΔRR=2.650±2.058;ΔPaO2/FiO2=13.205±2.279, P<0.05) before and after treatment, compared with the C group was significantly (P <0.05). The T group mechanical ventilation time was shorter than C group(164.32±19.72 vs 183.03±16.74, P<0.05). There was no significant difference in ICU hospitalization time and the mortality between 2 groups.Conclusions:Infusion of exogenous albumin in the early stage of ARDS patients can effectively maintain the serum albumin level and reduce serum inflammation marker protein CRP and HMGB1 level. High level of serum albumin can inhibit protein leakage from pulmonary capillaries. Exogenous albumin infusion can improve the clinical symptoms, correct patients hypoalbuminemia, and shorten the time of mechanical ventilation. Although it cannot change the final result of patients, it facilitates the further comprehensive therapy of patients with ARDS.