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Coagulation changes after albumin resuscitation

The administration of albumin in the initial resuscitation of shock remains highly controversial. Impaired coagulation in the critically injured patient has recently been added as an argument against the use of supplemental albumin. This study investigated the hemostatic effects of albumin therapy after hemor-rhagic shock. Twenty mongrel dogs were bled to a systolic pressure of 60 mm Hg for 1 h. After the return of shed blood, the animals received either lactated Ringer's solution or 5% serum albumin (25 ml/kg) daily for the 3 days. Coagulation parameters were measured before bleeding, immediately after resuscitation, and on days 2, 3, and 4. The changes in platelet count, platelet function, and serum fibrinogen were similar in the albumin treated and control animals. Although the prothrombin time and partial thromboplastin time were more prolonged in the albumin group, the changes were not sufficient to produce clinical bleeding.