RT Journal A1 Johnson SD, Lucas CE, Gerrick SJ, Ledgerwood AM, Higgins RF T1 ALtered coagulation after albumin supplements for treatment of oligemic shock JF Archives of Surgery JO Archives of Surgery YR 1979 FD April 1 VO 114 IS 4 SP 379 OP 383 DO 10.1001/archsurg.1979.01370280033005 UL http://dx.doi.org/10.1001/archsurg.1979.01370280033005 AB • Coagulation and need for postoperative blood and plasma therapy were studied in 94 injured patients requiring massive transfusions (average = 14.4); 46 patients, by random selection, received supplemental albumin. Albumin therapy increased total protein concentration (6.4 vs 5.8 g/dL), serum albumin level (4.2 vs 2.9 g/dL), and plasma volume (3,895 vs 3,579 mL) but not RBC volume (1,520 vs 1,530 mL). During the initial five postoperative days, patients receiving albumin required more transfusions (7.1 vs 3.8) and plasma (455 vs 317 mL). This increased need for blood and plasma correlated with a significant decrease in fibrinogen (238 vs 405 mg/dL) and prolongation of the prothrombin time (2.6 vs 1.4 seconds). The partial thromboplastin time was prolonged and the platelet concentration was decreased in albumin-treated patients, but not significantly. Deficiencies in specific coagulation factors have not yet been identified but are being studied. Impaired coagulation is another potential hazard of supplemental albumin therapy, which is probably contraindicated in injured patients.(Arch Surg 114:379-383, 1979)