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Fluid Management Learning Zone

Key Issues Dialogue

Read time: 60 mins
Last updated:13th Mar 2020

Key Issues Dialogue: Albumin in Clinical Fluid Management

The Key Issues Dialogue meeting in 2013, sponsored by CSL Behring, was held to facilitate the exchange of information regarding the pros and cons of using albumin in volume replacement in complications of liver disease, in critically ill patients with a condition such as sepsis, and in cardiac surgery.

It featured experts from the medical community in the United States and Europe. Read their biographies at the bottom of the page.

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Participants biographies

Listed here are the biographies of all the leading experts that took part in the Key Issues Dialogue

Participants group photo

Front row, from left to right: Dr. Garrett E. Bergman, Dr. Mauro Bernardi and Dr. Greg S. Martin. Back row, from left to right: Dr. Gary R. Haynes, Dr. Georg Henkel, Dr. Thomas Machnig, Dr. Vicente Arroyo, Dr. Luciano Gattinoni and Dr. Albert Farrugia.

Vicente Arroyo, M.D.

Professor of Medicine, University of Barcelona Medical School

Vicente Arroyo’s main research interest is cardiocirculatory and renal failure, ascites, and acute bacterial infection in cirrhosis. He is the Director of the Esther Koplowitz Biomedical Research Center and Chairman of the Chronic Liver Failure European Consortium.

Vicente has been Director of the Digestic and Metabolic Diseases Department at the Hospital Clínic of Barcelona and Chairman of the Department of Medicine. His published work consists of original articles (274), editorial and review articles (154), books (22) and chapters of books (164), and he has delivered 346 invited lectures.

Vicente is a member of the Spanish, European, American and International Associations for the Study of the Liver.

Garrett E. Bergman, M.D.

Senior Director Medical Affairs NA – CSL Behring

Garrett E. Bergman leads the scientific and medical support to commercial operations for the North American business unit of the company. An academic pediatric haematologist for 15 years, Garrett has since worked in large pharmaceutical companies and small, biotech startups for more than 20 years, heading the Clinical Research & Development, Regulatory Affairs, and Medical Affairs divisions in several companies. He has led the successful development of several plasma-derived biologics and drugs.

Mauro Bernardi, M.D.

Professor of Internal Medicine, Department of Clinical Medicine, University of Bologna

Mauro Bernardi is noted for his research in cirrhosis and related complications, hepatocellular carcinoma, chronic viral hepatitis and liver transplantation. He teaches post-graduate courses in internal medicine, gastroenterology and infectious diseases in the University of Bologna medical school, and he is former director of the Department of Internal Medicine, Cardioangiology and Hepatology.

Mauro is a past member of the Scientific Committee of the Italian Association for the Study of the Liver, and of the governing Board of the European Association for the Study of the Liver (EASL). Currently, he is treasurer of EASL and vice-chairman of EASL-Chronic Liver Failure (CLIF) Consortium. He is a member of the editorial boards of Digestive and Liver Disease and Gut, and a former member of the Journal of Hepatology editorial board.

Albert Farrugia, Ph.D.

Vice President Global Access, Plasma Protein Therapeutics Association

Albert Farrugia is a widely recognized authority in blood and plasma therapeutics. Prior to the Plasma Protein Therapeutics Association, he worked in the blood and biotherapeutics sector in several countries and headed the Australian Therapeutic Goods Administration’s Blood and Tissue Services.

Albert is a Fellow of the British Institute of Biomedical Sciences. He has published over 120 papers, invited reviews and book chapters, and he has edited two books. His international appointments have included the WHO Global Blood Safety Collaboration, the European Pharmacopeia Commission, the US Pharmacopeia and the Council of Europe Committee Quality Assurance in Blood Transfusion.

Luciano Gattinoni, M.D.

Professor and Chairman, Department of Anesthesiology and Intensive Care, University of Milan; Chief, Department of Anesthesia, Resuscitation and Pain Therapy at Policlinico Hospital of Milan

Luciano Gattinoni’s research interests include parenteral nutrition, metabolic therapy, acid-base equilibrium, organization of intensive care units, cost-benefit analysis and prognostic indices. A recipient of the Society of Critical Care Medicine’s Lifetime Achievement Award, he has added to the understanding of lung function, including changes following acute injury and during critical illness

Luciano is the author or coauthor of more than 200 research articles and reviews, and he has led numerous cooperative investigative trials, some of which have been published in the British Medical Journal, the Journal of the American Medical Association and The New England Journal of Medicine. He is currently editor-in-chief of Minerva Anestesiologica and serves on the editorial and advisory boards of several journals.

Gary R. Haynes, M.D., Ph.D.

Professor and Chairman, Department of Anesthesiology and Critical Care, Saint Louis University School of Medicine; Operating Room Medical Director, Saint Louis University Hospital

Gary Haynes is a recognized authority on clinical fluid management with broad experience in perioperative systems and management, and complex clinical and medical organizational problems. His focus is on coupling technology and medical professionals.

Gary was previously Chief Resident, Anesthesia and continues to hold the position of Professor of Anesthesia at the Medical University of South Carolina. He has lectured widely on a range of clinical topics. These include various aspects of albumin, such as in perioperative management of cardiac surgical patients, and safety and efficacy as a resuscitative therapy in the ICU.

Gary’s work has been published in Academic Medicine, Southern Medical Journal, American Journal of Anesthesiology, Journal of Gynecologic Surgery and the European Journal of Anesthesiology, among other publications.

Georg Henkel, D.V.M.

Senior Director, Commercial Development Critical Care, CSL Behring

Georg Henkel has over 20 years of experience at CSL Behring and predecessor companies in marketing and sales of plasma-derived therapies. Georg is based in Marburg, Germany, and he is responsible for the Critical Care Product Portfolio of CSL Behring.

He previously worked in national as well as international functions and been responsible for regional and global launches. Georg also worked as a postdoctoral fellow at Rutgers University.

Greg S. Martin, M.D., M.Sc.

Associate Professor and Associate Division Director for Critical Care, Division of Pulmonary, Allergy and Critical Care at Emory University School of Medicine; Chief of Pulmonary/Critical Care and Director of Medical and Coronary Intensive Care, Grady Memorial Hospital

Greg Martin specializes in pulmonary and critical care medicine and he conducts clinical research with a particular focus on sepsis and acute lung injury. He directs the research program in Emory’s Center for Critical Care, chairs the Division ICU Standardization Committee, and serves as Director of the Medical and Coronary Intensive Care Units and Chair of the ICU Operations Committee at Grady Memorial Hospital. He also directs the Clinical Core of the Emory Alcohol and Lung Biology Center.z

Greg has written extensively about the causes and consequences of severe sepsis and lung injury, including contributions to Medscape/WebMD and Emory’s institutional publication Sound Science.

References

  1. Delaney AP , Dan A, McCaffrey J, Finfer S. The role of albumin as a resuscitation fluid for patients with sepsis: A systematic review and meta-analysis. Crit Care Med 2011;39:386-391.
  2. Cochrane Injuries Group Albumin Reviewers. Human albumin administration in critically ill patients: systematic review of randomised controlled trials. BMJ 1998;317:235-240.
  3. Delaney AP , Dan A, McCaffrey J, Finfer S. The role of albumin as a resuscitation fluid for patients with sepsis: A systematic review and meta-analysis. Crit Care Med 2011;39:386-391.
  4. Dart AB, Mutter TC, Ruth CA, Taback SP . Hydroxyethyl starch (HES) versus other fluid therapies: effects on kidney function. Cochrane Database Syst Rev 2010;1:CD007594.
  5. Zarychanski R, Turgeon AF, Fergusson DA, Cook DJ, Hébert P , Bagshaw SM, Monsour D, McIntyre L. Renal outcomes and mortality following hydroxyethyl starch resuscitation of critically ill patients: systematic review and meta-analysis of randomized trials. Open Med 2009;3:E196-209.
  6. Bernardi M., Caraceni P ., Navickis R.J., Wilkes M.M. Albumin Infusion in Patients Undergoing Large-Volume Paracentesis: A Meta-Analysis of Randomized Trials. Hepatology 2011Nov16 doi.10.1002/hep.24786.
  7. Sort P , Navasa M, Arroyo V, Aldeguer X, Planas R, Ruiz-del-Arbol L, Castells L, Vargas V, Soriano G, Guevara M, Ginès P , Rodés J. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis. N Engl J Med 1999;341:403-409.
  8. Sort P , Navasa M, Arroyo V, Aldeguer X, Planas R, Ruiz-del-Arbol L, Castells L, Vargas V, Soriano G, Guevara M, Ginès P , Rodés J. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis. N Engl J Med 1999;341:403-409.
  9. Fernández J, Monteagudo J, Bargallo X, Jiménez W, Bosch J, Arroyo V, Navasa M. A randomised unblinded pilot study comparing albumin versus hydroxyethyl starch in spontaneous bacterial peritonitis. Hepatology 2005;42:627-634.
  10. SAFE Study Investigators. Impact of albumin compared to saline on organ function and mortality of patients with severe sepsis. Intensive Care Med 2011;37:86-96.
  11. Caironi P , Gattinoni L. The clinical use of albumin: the point of view of a specialist in intensive care. Blood Transfus 2009;7:259-267.
  12. McIntyre L, Fergusson DA, Rowe B, Cook DJ, Arabi Y, Bagshaw SM, Emond M, Finfer S, FoxRobichaud A, Gray A, Green R, Hebert P , Lang E, Marshall J, Stiell I, Tinmouth A, Pagliarello J, Turgeon A, Walsh T, Worster A, Zarychanski R. The PRECISE RCT: Evolution of an Early Septic Shock Fluid Resuscitation Trial. Transfus Med Rev doi:10.1016/j.tmrv.2011.11.003.
  13. Maitland K, Kiguli S, Opoka RO, Engoru C, Olupot-Olupot P , Akech SO, Nyeko R, Mtove G, Reyburn H, Lang T, Brent B, Evans JA, Tibenderana JK, Crawley J, Russell EC, Levin M, Babiker AG, Gibb DM. Mortality after fluid bolus in African children with severe infection. N Engl J Med 2011;364:2483-2495.
  14. Martin GS, Mangialardi RJ, Wheeler AP , Dupont WD, Morris JA, Bernard GR. Albumin and furosemide therapy in hypoproteinemic patients with acute lung injury. Crit Care Med 2002;30:2175-2182.
  15. Martin GS, Moss M, Wheeler AP , Mealer M, Morris JA, Bernard GR. A randomized, controlled trial of furosemide with or without albumin in hypoproteinemic patients with acute lung injury. Crit Care Med 2005;33:1681-1687.

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