Higher Dosages of 25% Albumin Associated with Lower Incidence of Cerebral Ischemia and Infarction in Pilot ALISAH Study

The “Albumin in Subarachnoid Hemorrhage” (ALISAH) pilot clinical trial, conducted at the Baylor College of Medicine in Houston, assessed the neuroprotective effects of varying dosages of 25% human albumin. Vasospasm, delayed cerebral ischemia (DCI) and cerebral infarction were evaluated in 20 patients who received seven consecutive daily infusions of 0.625 g/kg (Tier 1), 20 who received 1.25 g/kg (Tier 2), and seven who received 1.875 g/kg (Tier 3).

Transcranial Doppler ultrasound (TCD) showed vasospasm in 75% (n=15), 55% (n=11) and 29% (n=2) of subjects in dosage Tiers 1, 2 and 3, respectively. DCI was present in 20% (n=4), 15% (n=3) and 14% (n=1) of subjects in the three escalating dosage tiers. Cerebral infarctions occurred in 45% (5/9), 27% (3/18) and 25% (1/4) of subjects who had followup head CT scans in dosage Tiers 1, 2 and 3, respectively. The investigators concluded that higher dosages of 25% albumin were associated with a lower incidence of TCD vasospasm and cerebral infarction at 90 days follow-up, in a dose-dependent manner.