Albumin supplementation in the critically ill. A prospective, randomized trial
E. F. Foley, B. C. Borlase, W. H. Dzik, B. R. Bistrian and P. N. Benotti
Department of Surgery, Harvard University Medical School, New England Deaconess Hospital, Boston, Mass.
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, less than
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.
Albumin administration in the management of neonatal hypoalbuminaemia
Morris and Molloy
Arch. Dis. Child. Fetal Neonatal Ed. 2008;93:F326-F326.
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Evidence-based Colloid Use in the Critically Ill: American Thoracic Society Consensus Statement
Am. J. Respir. Crit. Care Med. 2004;170:1247-1259.
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Hypoalbuminaemia in critically ill children: incidence, prognosis, and influence on the anion gap
Durward et al.
Arch. Dis. Child. 2003;88:419-422.
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Patient Survival after Human Albumin Administration: A Meta-Analysis of Randomized, Controlled Trials
Wilkes and Navickis
ANN INTERN MED 2001;135:149-164.
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The role of albumin in critical illness
Nicholson et al.
Br J Anaesth 2000;85:599-610.
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The Good, the Bad, and the Ugly: Should We Completely Banish Human Albumin from Our Intensive Care Units?
Boldt
Anesth. Analg. 2000;91:887-895.
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Human albumin administration in critically ill patients: systematic review of randomised controlled trials • Why albumin may not work
Reviewers and Reviewers
BMJ 1998;317:235-240.
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The Therapeutic Use of Albumin
Hastings and Wolf
Arch Fam Med 1992;1:281-287.
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Invited Review: Nutrition in the Neurologically Injured Patient
Ott and Young
Nutr Clin Pract 1991;6:223-229.
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