Polymerized albumin restores impaired hemodynamics in endotoxemia and polymicrobial sepsis

Abstract Fluid resuscitation following severe inflammation-induced hypoperfusion is critical for the restoration of hemodynamics and the prevention of multiorgan dysfunction syndrome during septic shock. Fluid resuscitation with commercially available crystalloid and colloid solutions only provides...

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Autores principales:	Donald A. Belcher, Alexander T. Williams, Andre F. Palmer, Pedro Cabrales
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c975693a2e82403babdaba58ccc0bc55
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spelling	oai:doaj.org-article:c975693a2e82403babdaba58ccc0bc552021-12-02T15:49:53ZPolymerized albumin restores impaired hemodynamics in endotoxemia and polymicrobial sepsis10.1038/s41598-021-90431-z2045-2322https://doaj.org/article/c975693a2e82403babdaba58ccc0bc552021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-90431-zhttps://doaj.org/toc/2045-2322Abstract Fluid resuscitation following severe inflammation-induced hypoperfusion is critical for the restoration of hemodynamics and the prevention of multiorgan dysfunction syndrome during septic shock. Fluid resuscitation with commercially available crystalloid and colloid solutions only provides transient benefits, followed by fluid extravasation and tissue edema through the inflamed endothelium. The increased molecular weight (M.W.) of polymerized human serum albumin (PolyHSA) can limit fluid extravasation, leading to restoration of hemodynamics. In this prospective study, we evaluated how fluid resuscitation with PolyHSA impacts the hemodynamic and immune response in a lipopolysaccharide (LPS) induced endotoxemia mouse model. Additionally, we evaluated fluid resuscitation with PolyHSA in a model of polymicrobial sepsis induced by cecal ligation and puncture (CLP). Resuscitation with PolyHSA attenuated the immune response and improved the maintenance of systemic hemodynamics and restoration of microcirculatory hemodynamics. This decrease in inflammatory immune response and maintenance of vascular wall shear stress likely contributes to the maintenance of vascular integrity following fluid resuscitation with PolyHSA. The sustained restoration of perfusion, decrease in pro-inflammatory immune response, and improved vascular integrity that results from the high M.W. of PolyHSA indicates that a PolyHSA based solution is a potential resuscitation fluid for endotoxic and septic shock.Donald A. BelcherAlexander T. WilliamsAndre F. PalmerPedro CabralesNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Donald A. Belcher Alexander T. Williams Andre F. Palmer Pedro Cabrales Polymerized albumin restores impaired hemodynamics in endotoxemia and polymicrobial sepsis
description	Abstract Fluid resuscitation following severe inflammation-induced hypoperfusion is critical for the restoration of hemodynamics and the prevention of multiorgan dysfunction syndrome during septic shock. Fluid resuscitation with commercially available crystalloid and colloid solutions only provides transient benefits, followed by fluid extravasation and tissue edema through the inflamed endothelium. The increased molecular weight (M.W.) of polymerized human serum albumin (PolyHSA) can limit fluid extravasation, leading to restoration of hemodynamics. In this prospective study, we evaluated how fluid resuscitation with PolyHSA impacts the hemodynamic and immune response in a lipopolysaccharide (LPS) induced endotoxemia mouse model. Additionally, we evaluated fluid resuscitation with PolyHSA in a model of polymicrobial sepsis induced by cecal ligation and puncture (CLP). Resuscitation with PolyHSA attenuated the immune response and improved the maintenance of systemic hemodynamics and restoration of microcirculatory hemodynamics. This decrease in inflammatory immune response and maintenance of vascular wall shear stress likely contributes to the maintenance of vascular integrity following fluid resuscitation with PolyHSA. The sustained restoration of perfusion, decrease in pro-inflammatory immune response, and improved vascular integrity that results from the high M.W. of PolyHSA indicates that a PolyHSA based solution is a potential resuscitation fluid for endotoxic and septic shock.
format	article
author	Donald A. Belcher Alexander T. Williams Andre F. Palmer Pedro Cabrales
author_facet	Donald A. Belcher Alexander T. Williams Andre F. Palmer Pedro Cabrales
author_sort	Donald A. Belcher
title	Polymerized albumin restores impaired hemodynamics in endotoxemia and polymicrobial sepsis
title_short	Polymerized albumin restores impaired hemodynamics in endotoxemia and polymicrobial sepsis
title_full	Polymerized albumin restores impaired hemodynamics in endotoxemia and polymicrobial sepsis
title_fullStr	Polymerized albumin restores impaired hemodynamics in endotoxemia and polymicrobial sepsis
title_full_unstemmed	Polymerized albumin restores impaired hemodynamics in endotoxemia and polymicrobial sepsis
title_sort	polymerized albumin restores impaired hemodynamics in endotoxemia and polymicrobial sepsis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/c975693a2e82403babdaba58ccc0bc55
work_keys_str_mv	AT donaldabelcher polymerizedalbuminrestoresimpairedhemodynamicsinendotoxemiaandpolymicrobialsepsis AT alexandertwilliams polymerizedalbuminrestoresimpairedhemodynamicsinendotoxemiaandpolymicrobialsepsis AT andrefpalmer polymerizedalbuminrestoresimpairedhemodynamicsinendotoxemiaandpolymicrobialsepsis AT pedrocabrales polymerizedalbuminrestoresimpairedhemodynamicsinendotoxemiaandpolymicrobialsepsis
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Polymerized albumin restores impaired hemodynamics in endotoxemia and polymicrobial sepsis

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