Albumin administration appears not to reduce mortality in patients with hypovolaemia or in critically ill patients with burns and hypoalbuminaemia.
A Cochrane review 1 included 38 trials reporting death as outcome. There were 1,958 deaths among 10,842 trial participants. For hypovolaemia, the relative risk of death following albumin administration was 1.02 (95% CI 0.92 to 1.13). This estimate was heavily influenced by the results of the SAFE trial which contributed 75.2% of the information (based on the weights in the meta-analysis). For burns, the relative risk was 2.93 (95% CI 1.28 to 6.72) and for hypoalbuminaemia the relative risk was 1.26 (95% CI 0.84 to 1.88). There was no substantial heterogeneity between the trials in the various categories. The pooled relative risk of death with albumin administration was 1.05 (95% CI 0.95 to 1.16).
Comment: The quality of evidence is downgraded by study limitations (inadequate allocation concealment). The possibility that there may be highly selected populations of critically ill patients in which albumin may be indicated remains open to question.
1. Roberts I, Blackhall K, Alderson P et al. Human albumin solution for resuscitation and volume expansion in critically ill patients. Cochrane Database Syst Rev 2011;(11):CD001208. [PMID:22071799]
Copyright © 2019 Duodecim Medical Publications Limited.
Albumin for resuscitation and volume expansion in critically ill patients
is a sample topic from the Evidence-Based Medicine Guidelines
To view other topics, please sign in or purchase a subscription.
Evidence Central is an integrated web and mobile solution that helps clinicians quickly answer etiology, diagnosis, treatment, and prognosis questions using the latest evidence-based research. Complete Product Information.
"Albumin for Resuscitation and Volume Expansion in Critically Ill Patients." Evidence-Based Medicine Guidelines, Duodecim Medical Publications Limited, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/EBMG/454984/all/Albumin_for_resuscitation_and_volume_expansion_in_critically_ill_patients.
Albumin for resuscitation and volume expansion in critically ill patients. Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. https://evidence.unboundmedicine.com/evidence/view/EBMG/454984/all/Albumin_for_resuscitation_and_volume_expansion_in_critically_ill_patients. Accessed December 9, 2019.
Albumin for resuscitation and volume expansion in critically ill patients. (2019). In Evidence-Based Medicine Guidelines. Available from https://evidence.unboundmedicine.com/evidence/view/EBMG/454984/all/Albumin_for_resuscitation_and_volume_expansion_in_critically_ill_patients
Albumin for Resuscitation and Volume Expansion in Critically Ill Patients [Internet]. In: Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. [cited 2019 December 09]. Available from: https://evidence.unboundmedicine.com/evidence/view/EBMG/454984/all/Albumin_for_resuscitation_and_volume_expansion_in_critically_ill_patients.
TY - ELEC
T1 - Albumin for resuscitation and volume expansion in critically ill patients
ID - 454984
BT - Evidence-Based Medicine Guidelines
UR - https://evidence.unboundmedicine.com/evidence/view/EBMG/454984/all/Albumin_for_resuscitation_and_volume_expansion_in_critically_ill_patients
PB - Duodecim Medical Publications Limited
DB - Evidence Central
DP - Unbound Medicine