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Randomized trials have not demonstrated a survival benefit, and the effects of albumin on volemia remain unclear. This study investigates, in healthy pigs, the effects of a 48-h albumin infusion on intravascular fluid volume, albumin kinetics, and its impact on respiratory function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Thirty-nine healthy female pigs ventilated for 48\u00a0h were grouped according to mechanical power (high\u2009~\u200918\u00a0J\/min vs. low\u2009~\u20096\u00a0J\/min) and type of fluid (5% albumin solution vs. crystalloid), generating four experimental groups: MP\n                      <jats:sub>LOW<\/jats:sub>\n                      -Crystalloid; MP\n                      <jats:sub>LOW<\/jats:sub>\n                      -Albumin; MP\n                      <jats:sub>HIGH<\/jats:sub>\n                      -Crystalloid; and MP\n                      <jats:sub>HIGH<\/jats:sub>\n                      -Albumin.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Intravascular fluid volume was similar across groups (MP\n                      <jats:sub>LOW<\/jats:sub>\n                      -Crystalloid: 1.92 (\u00b1\u20090.38)L; MP\n                      <jats:sub>HIGH<\/jats:sub>\n                      -Crystalloid: 1.72 (\u00b1\u20090.40)L; MP\n                      <jats:sub>LOW<\/jats:sub>\n                      -Albumin: 1.86 (\u00b1\u20090.37)L; MP\n                      <jats:sub>HIGH<\/jats:sub>\n                      -Albumin: 2.10 (\u00b1\u20090.58)L;\n                      <jats:italic>p<\/jats:italic>\n                      0.389). For the same mechanical power, the fraction of albumin lost from the plasma was higher in the albumin compared to the crystalloid groups (MP\n                      <jats:sub>LOW<\/jats:sub>\n                      -Albumin: 62 (\u00b1\u200913)% vs. MP\n                      <jats:sub>LOW<\/jats:sub>\n                      -Crystalloid: \u2212\u00a016 (\u00b1\u200966)%; and MP\n                      <jats:sub>HIGH<\/jats:sub>\n                      -Albumin: 58 (\u00b1\u200924)% vs. MP\n                      <jats:sub>HIGH<\/jats:sub>\n                      -Crystalloid: 29 (\u00b1\u200914)%;\n                      <jats:italic>p\u2009<\/jats:italic>\n                      &lt;\u20090.001). Albumin groups showed greater ascites (MP\n                      <jats:sub>LOW<\/jats:sub>\n                      -Crystalloid: 261 (\u00b1\u2009380)mL; MP\n                      <jats:sub>HIGH<\/jats:sub>\n                      -Crystalloid: 144 (\u00b1\u2009148)mL; MP\n                      <jats:sub>LOW<\/jats:sub>\n                      -Albumin: 710 (\u00b1\u2009664)mL; MP\n                      <jats:sub>HIGH<\/jats:sub>\n                      -Albumin: 685 (\u00b1\u2009651)mL;\n                      <jats:italic>p<\/jats:italic>\n                      0.034), and worse end-expiratory lung gas volume and elastance, despite comparable histological damage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In our cohort, prolonged albumin infusion did not lead to a difference in intravascular fluid volume, but it resulted in the loss of\u2009~\u200960% of the infused albumin and ascites development. Ascites was associated with lower end-expiratory lung gas volume and higher elastance, despite similar histological lung damage across the groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40635-026-00853-0","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T02:04:44Z","timestamp":1770257084000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Albumin kinetics, intravascular fluid volume, and respiratory function in pigs ventilated at different levels of mechanical power following crystalloid vs. albumin infusion"],"prefix":"10.1186","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5047-9246","authenticated-orcid":false,"given":"Simone","family":"Gattarello","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaetano","family":"Gazz\u00e9","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Rollo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatrice","family":"Donati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Caronna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilaria","family":"Grava","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Chiumiento","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhe","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter","family":"Gallese","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domenico","family":"Nocera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Giovanazzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aurelio","family":"Sonzogni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Sonzogni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Gatta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Collino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Camporota","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Quintel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Onnen","family":"Moerer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Romitti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luciano","family":"Gattinoni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mattia","family":"Busana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"issue":"3","key":"853_CR1","first-page":"257","volume":"22","author":"S Bihari","year":"2020","unstructured":"Bihari S, Bannard-Smith J, Bellomo R (2020) Albumin as a drug: its biological effects beyond volume expansion. 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