Physiological Effects of Albumin on Water Movement (Nursing)

00:01 So what about the liver? I mean we've been talking a lot about the feet, the cankles, the pitting.

00:06 What does this have to do with the liver? I thought that's what we were talking about.

00:10 Well, this is where it's very important for you to keep in mind, the liver and albumin have a very intense relationship.

00:18 The liver is important to creating proteins, patients with liver damage have less albumin.

00:25 Albumin is a protein.

00:27 Now think back to what we talked about earlier in the video series.

00:32 How do we end up with edema? Okay. Remember those capillaries get damaged.

00:36 Protein leaks out of the intravascular space and into the tissues and we know water is going to follow.

00:44 So albumin or protein is a powerhouse when it comes to keeping fluid where it's supposed to be.

00:51 So if I don't have enough of it because my liver is damaged that's definitely going to impact fluid balance in my body.

00:59 So the liver an albumin have an intense relationship because the liver is really important in creating proteins and albumin is the protein in our intravascular space.

01:11 So people with liver problems like cirrhosis are going to have fluid balance issues.

01:17 Now the liver can do hundreds of things.

01:19 We've already established that but I don't ever get tired of telling you that because I want you to remember this is an incredible organ.

01:27 Remember we're focusing on albumin, does lots of other things but I want you to really pay attention to albumin.

01:35 Now take a look at the liver there.

01:38 Let's use this as a quick chance to review the anatomy.

01:41 Now, you've got the liver, right? You've got the two segments of the liver.

01:45 Now take your finger and trace down that little green tube, coming out of the bottom of the liver. What is that? Right.

01:53 It is we've got the duct there, right? That's what carries the bile from the liver to the, what is that green balloon? That's your gallbladder.

02:03 Good deal.

02:04 Okay, so we know we're talking about the hepatobiliary track.

02:07 The first stop...

02:09 on the bile train is the gallbladder acts like a garage for your bile.

02:14 So we've got the liver.

02:16 We see the red blood supply there's an artery but what I want you to do is put your finger on what we call the portal vein.

02:23 Now if I trace that portal vein down to what's the next body part it's going to come too.

02:30 It's going to come to your gut.

02:31 Remember you eat something goes in your mouth down into your stomach right into your duodenum through your intestines and you're sent back up all the nutrients and things through that portal vein system to your liver to be processed.

02:47 Okay, so that portal vein plays a really important role.

02:50 That's why I wanted to stop here and spend a little time with it.

02:53 Remember if I filed that portal vein down.

02:56 What is it going to go towards? Your gut.

02:58 It's going to go toward the vein system of the gut.

03:01 Now what does that portal vein deliver to the liver? All kinds of nutrients and things from the food you've eaten and your gut is chewing up.

03:10 That's how it comes back to the liver for further processing.

03:14 Now albumin is a major protein that circulates in the plasma and it's produced by the liver.

03:22 I'm stopping right here because I want to make sure you have that point.

03:26 So albumin is the major protein that's in your plasma and is produced by the liver.

03:33 That's why they have such an intense relationship.

03:38 Albumin is in my intravascular space.

03:40 It's in my plasma, has significant control over fluid volume balance, and it's produced by the liver.

03:48 So anyone who has a liver that struggling like cirrhosis, then I know they're not going to have enough albumin to keep fluid in appropriate spaces and balance.

03:59 Now, look at this.

04:00 This is such a cool graphic I asked them to create for you and look what they did.

04:06 Okay, so the little red and white things those are albumin but green dots are sodium and then you see what we have for water 2 hydrogen 1 oxygen.

04:18 Okay, so human serum albumin is charged so it attracts sodium.

04:23 You've heard me say it but now let's look at it.

04:26 Look at the albumin and you've got the sodium, and you've got the water.

04:31 So let's watch that animation one more time.

04:36 Okay so there you have, moving through the system, look what's moving in is sodium.

04:41 Good.

04:42 Alright, so you see the albumin moved through your intravascular space.

04:47 When it moved in sodium joined it.

04:50 Now what's going to be the next thing that happens because the albumin is in your intravascular space.

04:56 You see that it was attracting sodium wherever sodium goes what follows? Right.

05:03 Water follows, so here it comes.

05:07 Okay, this is simple but brilliant.

05:10 I want you to even see it again because this concept is going to impact so many other systems and other assessments that you're going to do as a nurse.

05:20 All right, so let's back it up because I don't want you to miss what this is.

05:25 Now let's go back over.

05:26 What is the big long red strip down the middle of the picture? That's your intravascular space.

05:33 That's a blood vessels.

05:34 So when we say intravascular, it's within the vascular system, a blood vessel.

05:40 What are those kind of...

05:42 what are those kind of skin colored boxes or things outside of it? That represents the interstitial space.

05:51 Now, there's a darker red line right on the top and the bottom of your vessel.

05:58 That's the capillary.

06:00 That's the thing that we told you is so very fragile, and we need protein to stay inside the intravascular space so it can attract sodium and water appropriately.

06:10 So we've got those interstitial spaces those cells outside in between the capillary and the inside of the vascular space.

06:20 Everybody with us? Okay good deal.

06:22 So we know that, human serum albumin is charged in a way that it attracts sodium.

06:29 So look for the albumin.

06:30 You're going to ready for it, when you see it.

06:32 You're going to see it traveling on down, there it comes.

06:35 It appears.

06:36 Good job! Now it's attracting sodium because it's charged that way.

06:41 So sodium is a positive, albumin attracts the sodium into the intravascular space, then what happens? You got it.

06:50 Water follows, because wherever sodium goes water follows.

06:55 This is a healthy body.

06:57 This is how it's supposed to work.

06:59 You need to have enough albumin to attract the sodium and so you've got a appropriate water levels inside your body when we're talking about cirrhosis.

07:08 This is all out of whack.

07:11 I don't have enough albumin in my intravascular space in my serum because a limping liver just can't make it.