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Hemodynamic response to rapidly infused 25% albumin in sheep: blunting the effects with ibuprofen.

We document the hemodynamic deterioration in two patients given very rapid intravenous infusions of 25% albumin. We developed an animal model to further elucidate the mechanism involved. Seven sheep were instrumented for the measurement of cardiac index (CI), pulmonary artery pressure (PAP), mean arterial pressure (MAP), left atrial pressure (LAP) and given 0.5 g/kg of Hyland brand 25% albumin over 5 min. Systemic vascular resistance index (SVRI), pulmonary vascular resistance index and left and right ventricular stroke work index were calculated. Equal volumes of normal saline were given to the same sheep as controls. Albumin significantly (p less than 0.05) increased MAP, PAP, LAP and SVRI, while CI decreased over the 3-10-min interval. Ibuprofen (14 mg/kg) intravenously administered 15 min prior to albumin, blunted all the above responses. This implicates a prostanoid as the possible mediator of these changes.