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A Prospective, Randomized Trial

Eugene F. Foley, MD; Bradley C. Borlase, MD; Walter H. Dzik, MD; Bruce R. Bistrian, MD, PhD; Peter N. Benotti, MD

Arch Surg. 1990;125(6):739-742.

Abstract
• Albumin replacement to correct hypoalbuminemia in critically ill patients has been controversial. This study was a prospective, randomized trial of 25% albumin administration in 40 hypoalbuminemic (serum albumin, 25 g/L [2.5 g/dL]), critically ill patients. The treatment group (18 patients) received 25% albumin supplementation to achieve and maintain serum albumin levels of 25 g/L (2.5 g/dL) or greater, while the nontreatment group (22 patients) received no concentrated albumin. There was no clinical benefit from albumin therapy when assessing mortality (39% vs 27%, treatment vs control) or major complication rate (89% vs 77% of patients). There were also no significant differences in length of hospital stay, intensive care unit stay, ventilator dependence, or tolerance of enteral feeding, despite significant elevations of albumin in the treatment group. The costly use of exogenous albumin as treatment for hypoalbuminemia in this patient population does not appear to be justified.

(Arch Surg. 1990;125:739-742)

Author Affiliations
From the Departments of Surgery (Drs Foley, Borlase, and Benotti) and Medicine (Drs Dzik and Bistrian), Harvard University Medical School, New England Deaconess Hospital, Boston, Mass.

Footnotes
Accepted for publication February 18, 1990.

Read before the 70th Annual Meeting of the New England Surgical Society, Bretton Woods, NH, September 23, 1989.

Reprint requests to Department of Surgery, Suite 3A, 110 Francis St, Boston, MA 02215 (Dr Benotti).

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