Change Of The Difference Between Hematocrit And Plasma-albumin In Patients With Systematic Capillary Leak Syndrome:Literature Review

Objective:Systematic Capillary Leak Syndrome(SCLS) is mainly diagnosed by clinical experience, that mainly relies on clinical symptoms and signs. The diagnosis of SCLS should meet 3 of Gousseff criterias or more(edema with acute weight gain of> 1 kg in< 1 week, systolic blood pressure< 100 mm Hg or mean blood pressure< 70 mm Hg, hemoglobin elevation, hypoalbuminemia). The pathological and physiological characteristics of SCLS is that small molecules, such as Albumin(Alb), could leak out of the capillary but erythrocytes(without angiorrhexis) couldn’t do this, which leads to the result of hematocrit(Hct) elevation and hypoalbuminemia. At the same time, we found that there was a close approximation between Hct(%) and Alb(g/L) in the healthy, but the absolute value of the difference between Hct and Alb became larger when SCLS occurred(the larger the value the more serious the severity). In this descriptive study, data(Hct, Alb, Administration, change of body weight, length of stay, fatality rate) in the SCLS course were from 20 years’ case reports, and the change of the difference between Hct and Alb in SCLS was also been researched. What is more,5000 physical examination data(Hct, Alb, age, sex, etc) were collected from Kunming medical examination center which was used for the analysis of the normal difference between Hct and Alb.Method:This is a descriptive study that consists of SCLS patients and gen eral population. we performed a systematic literature review in PubMed using t he search terms:"(("capillary leak"[Title/Abstract] OR "vascular leak"[Title/Abst ract] OR "vascular permeability" [Title/Abstract]) AND (" 1996/01/01 "[PDAT]:" 2015/9/30"[PDAT])) AND ("case reports"[Publication Type] OR "case report"[A 11 Fields]) AND "humans" [MeSH Terms]" to find the case reports relevant to human’s capillary leak between Jan 1,1996 and sept 30,2015. Then 281 artic les were found in which eventually remaining 213 articles through eliminating the cases just about brain capillary leak and eyes capillary leak. However, at 1 ast just 173 full texts were left. The SCLS cases must meet 3 of Gousseff cr iterias or more(edema with acute weight gain of> 1 kg in< 1 week, systolic blood pressure< 100 mm Hg or mean blood pressure< 70 mm Hg, Hgb ele vation, hypoalbuminemia), and the including cases should have exact data of H ct/Hb and Alb in capillary leak period whose date,such as Hct, Alb, Administ ration, change of body weight, length of stay and fatality rate, were collected f or analysis. The 5000 physical examination data of the general population were collected from Kunming medical examination center which included Hct and Alb.Results:(1) Before SCLS onset, the mean±SD of Hct, Alb and the diffe rence are 37.01±6.14,35.19±6.14 and 1.82±7.97, respectively(n=17). The mea n±SD of the data above on onset are 53.64±14.30,21.58±7.22 and 32.06±17. 41, respectively(n=84). In post-treatment, the values above are 34.17±5.37,3 3.62±6.09 and 0.55±8.81,respectively(n=12). (2) the mean±SD of the dif ference between Hct and Alb in SCLS is 32.06±17.41, and in general popu lation it’s-1.55±5.32. (3) there is a positive correlation between the di fference(Hct-Alb) and 24h administration(mean±SD is 9.82±4.95L) with a 0. 578 correlation coefficient, P<0.05.Conclusion:In this study that included SCLS case reports published from 1996 to 2015, we found that:(1) The difference between Hct and Alb on SCLS onset is 32.06±17.41; (2) The larger the difference above(Hct-Alb), the more infusion patients needed. (3) The difference(Hct-Alb) before and after onset is similar to general population.