Альбумін у терапії критичних станів, зокрема при прееклампсії

Despite the well-documented physicochemical and pharmacodynamic properties of albumin solutions and the availability of clinical guidelines for their use in critical conditions, several aspects of their application, particularly in the context of pre-eclampsia, remain a matter of clinical debate. Aim: to ascertain the effect of intravenous human albumin solution on the inflammatory process activity in the postpartum period in women with pre-eclampsia. Materials and methods. 60 women aged 18 to 40 years in the third trimester of pregnancy complicated by moderate or severe pre-eclampsia were assigned to 2 groups of 30 patients each according to the prespecified inclusion and exclusion criteria. Group I patients were given a standard therapy after delivery. Group II patients were treated with the same therapy combined with continuous infusions of 20 % albumin solution (8 ml/h – on day 1; 4 ml/h – on days 2 and 3) and furosemide (0.05 mg/kg/h – on day 1; 0.025 mg/kg/h – on days 2 and 3) for 72 hours. Serum concentrations of interleukins (IL)-6 and IL-10 were measured, and the IL-6 / IL-10 ratio (inflammation index) was calculated before the onset of labor, and on days 1 and 3 of the postpartum period. Results. The analysis has shown the inflammatory index of 120 % higher the normal in the third trimester of uncomplicated pregnancy, indicating a slight prenatal increase in inflammatory processes. Moderate or severe pre-eclampsia in the same period has been found to be accompanied by significantly increased IL-6/IL-10 ratios by 523.3–570.0 %, showing the significant activation of inflammatory processes. The use of albumin infusion in combination with low doses of furosemide according to the method developed by us has proven the possibility to correct the inflammatory process activity. So, with infusions on the 1st day postpartum, the IL-6 / IL-10 ratio was decreased and exceeded the norm for non-pregnant women by 866.7 % versus 1696.7 % in Group 1 women. On the 3rd day after childbirth, the inflammatory index exceeded the norm by only 116.7 % with intravenous albumin, while in Group 1 (control), it remained 730.0 % higher than the norm. Conclusions. Intravenous combination of albumin solution with furosemide in the postpartum period according to the authors’ method has helped to significantly reduce the inflammatory index in parturient women with pre-eclampsia.