Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Albumin versus normal saline for dehydrated term infants with metabolic acidosis due to acute diarrhea

Journal of Perinatology volume 29, pages 444–447 (2009)Cite this article

Abstract

Objective:

To compare the efficacy of albumin to normal saline (NS) for initial hydration therapy for dehydrated term infants with severe metabolic acidosis due to acute diarrhea.

Study Design:

We randomized 33 infants presenting with moderate-to-severe dehydration and metabolic acidosis (pH <7.25 or base excess (BE) <−15) into two groups, an albumin group (n=15) and a NS group (n=18). For initial hydration treatment, the albumin group received 5% albumin (10 ml kg−1), whereas the NS group received NS (10 ml kg−1).

Result:

After 3 h of treatment, both groups improved. However, the magnitude of improvement in the pH, BE and HCO3− levels were not different in comparisons between these two groups. In addition, there were no differences either in the body weight and weight gain 4 days after treatment or in the length of hospital stay.

Conclusion:

Albumin was not more effective than NS for initial hydration treatment of dehydrated term infants with metabolic acidosis due to acute diarrhea.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Doweiko JP, Nompleggi DJ . Role of albumin in human physiology and pathophysiology. JPEN J Parenter Enteral Nutr 1991; 15: 207–211.

    Article  CAS  Google Scholar 

  2. Belgaumkar A, Greenough A, Kavvadia V, Dimitriou G . Metabolic acidosis: response to albumin infusion. Eur J Pediatr 1998; 157: 520–521.

    Article  CAS  Google Scholar 

  3. Dimitriou G, Greenough A, Mantagos J, Skinner S . Metabolic acidosis, core-peripheral temperature difference and blood pressure response to albumin infusion in hypotensive, very premature infants. J Perinat Med 2001; 29: 442–445.

    Article  CAS  Google Scholar 

  4. Dixon H, Hawkins K, Stephenson T . Comparison of albumin versus bicarbonate treatment for neonatal metabolic acidosis. Eur J Pediatr 1999; 158: 414–415.

    Article  CAS  Google Scholar 

  5. Lawn CJ, Weir FJ, McGuire W . Base administration or fluid bolus for preventing morbidity and mortality in preterm infants with metabolic acidosis. Cochrane Database Syst Rev 2005; 2: CD003215.

    Google Scholar 

  6. Narchi H . Is an intravenous fluid bolus of albumin or normal saline beneficial in the treatment of metabolic acidosis in a normovolaemic newborn? Arch Dis Child 2004; 89: 884–885.

    Article  Google Scholar 

  7. Kliegman RM, Behrman RE, Jenson HB, Stanton BF . Nelson textbook of pediatrics. WB Saunders CO: Philadelphia, 2007, pp 313.

    Google Scholar 

  8. Wilkes MM, Navickis RJ . Patient survival after human albumin administration. A meta-analysis of randomized, controlled trials. Ann Intern Med 2001; 135: 149–164.

    Article  CAS  Google Scholar 

  9. Vincent JL, Wilkes MM, Navickis RJ . Safety of human albumin—serious adverse events reported worldwide in 1998–2000. Br J Anaesth 2003; 91: 625–630.

    Article  CAS  Google Scholar 

  10. von Hoegen I, Waller C . Safety of human albumin based on spontaneously reported serious adverse events. Crit Care Med 2001; 29: 994–996.

    Article  CAS  Google Scholar 

  11. Jardine LA, Jenkins-Manning S, Davies MW . Albumin infusion for low serum albumin in preterm newborn infants. Cochrane Database Syst Rev 2004; 3: CD004208.

    Google Scholar 

  12. Oca MJ, Nelson M, Donn SM . Randomized trial of normal saline versus 5% albumin for the treatment of neonatal hypotension. J Perinatol 2003; 23: 473–476.

    Article  CAS  Google Scholar 

  13. So KW, Fok TF, Ng PC, Wong WW, Cheung KL . Randomised controlled trial of colloid or crystalloid in hypotensive preterm infants. Arch Dis Child Fetal Neonatal Ed 1997; 76: F43–F46.

    Article  CAS  Google Scholar 

  14. Lynch SK, Mullett MD, Graeber JE, Polak MJ . A comparison of albumin-bolus therapy versus normal saline-bolus therapy for hypotension in neonates. J Perinatol 2008; 28: 29–33.

    Article  CAS  Google Scholar 

  15. Greenough A, Emery E, Hird MF, Gamsu HR . Randomised controlled trial of albumin infusion in ill preterm infants. Eur J Pediatr 1993; 152: 157–159.

    Article  CAS  Google Scholar 

  16. Kavvadia V, Greenough A, Dimitriou G, Hooper R . Randomised trial of fluid restriction in ventilated very low birthweight infants. Arch Dis Child Fetal Neonatal Ed 2000; 83: F91–F96.

    Article  CAS  Google Scholar 

  17. Greenough A, Cheeseman P, Kavvadia V, Dimitriou G, Morton M . Colloid infusion in the perinatal period and abnormal neurodevelopmental outcome in very low birth weight infants. Eur J Pediatr 2002; 161: 319–323.

    Article  Google Scholar 

  18. Jobe A, Jacobs H, Ikegami M, Berry D . Lung protein leaks in ventilated lambs: effects of gestational age. J Appl Physiol 1985; 58: 1246–1251.

    Article  CAS  Google Scholar 

  19. Nitta K, Kobayashi T . Impairment of surfactant activity and ventilation by proteins in lung edema fluid. Respir Physiol 1994; 95: 43–51.

    Article  CAS  Google Scholar 

  20. Seeger W, Gunther A, Walmrath HD, Grimminger F, Lasch HG . Alveolar surfactant and adult respiratory distress syndrome. Pathogenetic role and therapeutic prospects. Clin Investig 1993; 71: 177–190.

    Article  CAS  Google Scholar 

  21. Maitland K, Pamba A, English M, Peshu N, Marsh K, Newton C et al. Randomized trial of volume expansion with albumin or saline in children with severe malaria: preliminary evidence of albumin benefit. Clin Infect Dis 2005; 40: 538–545.

    Article  Google Scholar 

  22. Juca CA, Rey LC, Martins CV . Comparison between normal saline and a polyelectrolyte solution for fluid resuscitation in severely dehydrated infants with acute diarrhoea. Ann Trop Paediatr 2005; 25: 253–260.

    Article  Google Scholar 

Download references

Acknowledgements

This study was supported by a Korea University Grant and by the Hin Moe (Dr Hyun-Gum Lee) Research Foundation. We thank the physicians and nursing staff working in the neonatal intensive care unit and the pediatric general ward of Korea University Ansan Hospital for their enthusiastic support and cooperation.

Author information

Authors and Affiliations

  1. Department of Pediatrics, College of Medicine, Korea University, Seoul, Republic of Korea

    J J Han, H E Yim, J H Lee, Y K Kim, G Y Jang, B M Choi, K H Yoo & Y S Hong

Authors
  1. J J Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H E Yim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J H Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Y K Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G Y Jang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. B M Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. K H Yoo
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Y S Hong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to B M Choi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Han, J., Yim, H., Lee, J. et al. Albumin versus normal saline for dehydrated term infants with metabolic acidosis due to acute diarrhea. J Perinatol 29, 444–447 (2009). https://doi.org/10.1038/jp.2008.244

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2008.244

Keywords

This article is cited by

Search

Advanced search

Quick links