Albumin Infusion Therapy in Stroke, Sepsis and the Critically Ill
Undurti N. Das.
Albumin is a complex molecule that is a principal transporter of plasma fatty acids and binds to majority of the drugs ingested. Albumin traps oxygen radicals and has anti-oxidant actions that exceed that of vitamin E. Vascular endothelial cells express specific binding sites for albumin that may aid in its ability to prevent endothelial cell apoptosis. Albumin regulates the enzyme pyruvate dehydrogenase in astrocytes and thus helps in the flux of glucose and lactate. Thus, albumin could limit ischemia-induced neuronal damage. Recent studies showed that intravenous albumin administration improved neurological function by reducing infarction volume and cerebral edema. In addition, albumin seems to be useful in the treatment of in those who are critically ill due to due to medical and surgical conditions, and sepsis. The cytoprotective action of albumin is due to an increase in the formation of protectins from docosahexaenoic acid (DHA) and possibly, other polyunsaturated fatty acids.
Keywords: Sepsis, critical illness, albumin, docosahexaenoic acid, polyunsaturated fatty acids, lipoxins, resolvins, neuroprotectin D1, stroke, neuroprotection
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