The purpose of this study is to evaluate whether patients receiving human albumin for plasma
volume replacement during cardiac surgery have improved postoperative endothelial function
compared to patients receiving 6% hydroxyethyl starch solutions. The postoperative
endothelial function, measured with peripheral arterial tonometry as reactive hyperemia index
(RHI) within 2 hours following surgery, will be compared in cardiac surgical patients
randomized to receive human albumin or 6% HES solutions for intraoperative volume
replacement. Within two hours of arrival to the ICU peripheral arterial tonometry using
EndoPAT will be performed. In a subset of 40 consecutive patients the investigators will
perform additional EndoPAT measurements to describe the expected changes that occur in
endothelial function during the perioperative period (baseline, early postoperative and 24
hours postoperative) using RHI.
This study will also determine whether human albumin 5% reduces plasma biomarkers of
endothelial and glycocalyceal damage by measuring plasma concentrations of syndecan 1 and
endocan at baseline (before surgery), and 1 and 24 hours following surgery. Blood samples
will be taken on the morning of the surgery, within one hour of arrival to the intensive care
unit (ICU), and 24 hours after surgery or within 2 hours before discharge from the ICU (three
times altogether). These samples will be used to measure the plasma concentrations of two
biomarkers that measure endothelial injury.