ORIGINAL ARTICLESSmall Volume Albumin Administration Protects Against Hemorrhagic Shock-Induced Bone Marrow DysfunctionOsband, Adena J. MD; Sifri, Ziad C. MD; Wang, Lai BS; Cohen, David MD; Hauser, Carl J. MD; Mohr, Alicia M. MD; Deitch, Edwin A. MD; Livingston, David H. MDAuthor Information From the Division of Trauma, Department of Surgery, New Jersey Medical School, Newark, New Jersey. Submitted for publication June 18, 2003. Accepted for publication October 16, 2003. This study was supported in part by grant NIH GM 59841 (EAD). Presented, in part, at the 33rd Annual Meeting of the Western Trauma Association, February 23–28, 2003, Snowbird, Utah. Address for reprints: David H. Livingston, MD, University Hospital M234, 150 Bergen Street, Newark, NJ 07103; email: [email protected]. The Journal of Trauma: Injury, Infection, and Critical Care: February 2004 - Volume 56 - Issue 2 - p 279-283 doi: 10.1097/01.TA.0000106431.84090.02 Buy Metrics Abstract Background Unexpected immunomodulatory effects of colloids and crystalloids prompted an investigation of albumin’s ability to prevent bone marrow (BM) suppression following trauma/hemorrhagic shock (T/HS: laparotomy + MAP 30 for 90 mins). Methods In vitro: Normal rat BM was plated for granulocyte-macrophage (CFU-GM) and erythrocyte colony forming units (BFU-E) with 2% v/v plasma from sham (T/SS) or T/HS rats and albumin (2–8 mg/mL). In vivo: Male rats (n = 4/group) were subjected to T/SS or T/HS and resuscitated with shed blood and twice the volume as Lactated Ringer’s (LR) or blood and 1, 2, or 3 mL of albumin (50 mg/mL). Bone marrow harvested 3 hours post-resuscitation was plated for CFU-GM and BFU-E. Results In vitro: T/HS plasma decreased both CFU-GM and BFU-E growth as compared with T/SS, whereas increasing doses of albumin showed dose-dependent improvement in progenitor growth (p < 0.05). In vivo: The suppression of BM red and white cell progenitor growth seen in T/HS+LR rats as compared with T/SS was fully prevented by as little as 1 mL of albumin (p < 0.05). Conclusions Small doses of albumin fully restore CFU-GM and BFU-E to sham values. We postulate that the binding of circulating toxic factors by albumin may play a role in this prevention of T/HS-induced BM suppression. © 2004 Lippincott Williams & Wilkins, Inc.