Albumin solution as an important component of intensive infusion therapy in women with preeclampsia

Аннотация

The aim of the study is to determine the efficiency and effectiveness of albumin solution in intensive infusion therapy for pregnant women with preeclampsia based on measuring indicators of central and peripheral hemodynamics, body water compartments, and markers of inflammation. 60 women were divided into two groups and examined. The first group (n=30) included women whose average age was 30.06±5.13 years, gestation period – 260.18±6.34 days. 16.7% of women in this group had moderate preeclampsia, 83.3% – severe preeclampsia. Patients of this group received standard intensive infusion therapy according to approved treatment protocols. The second group (n=30) included women, whose average age was 30.62±6.02 years, and pregnancy period 258.75±5.74 days. The patients of this group received intensive infusion therapy, like the women of the first group but in combination with a continuous infusion of a 20% albumin solution (8 ml/h – on the 1 st day; 4 ml/h – on the 2nd and 3rd day) and furosemide (0.05 mg/kg/h – on the 1st day; 0.025 mg/kg/h – on the 2nd and 3rd day) for 72 hours starting from the moment of the end of vaginal delivery or Cesarean section surgery. The comparative analysis showed that the dynamics of changes in the main indicators of homeostasis, hemodynamics, body water compartments and markers of inflammation in parturient women with preeclampsia strongly depend on the type of intensive infusion therapy. In women with preeclampsia, continuous administration of a 20% albumin solution immediately after delivery ensures the normalization of body water compartments till the 7th day of the postpartum period. It is the result of a rapid decrease in the total volume of fluid (by 17.2%, p<0.001 from the baseline) and interstitium (by 31.8%, p<0.001 from the prenatal level). The provided treatment in parturient women with preeclampsia helps to ensure a eukinetic type of blood circulation from the 5th day of the postpartum period already. It is also accompanied by the restoration of adaptation mechanisms that participate in maintaining the proper functioning of the cardiovascular system. The use of albumin and furosemide solution infusion reduces the degree of the background inflammatory process by 3.8 times (according to the index of inflammatory activity IL-6/IL-10) which comes along with preeclampsia.