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Albumin in critical care: SAFE, but worth its salt?

Intravascular fluid therapy is a common critical care intervention. However, the optimal type of resuscitation fluid, crystalloid or colloid, remains controversial. Despite the many theoretical benefits of human albumin administration in critically ill patients, there has been little evidence to sup...

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Detalles Bibliográficos
Autores principales: Fan, Eddy, Stewart, Thomas E
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2004
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1065031/
https://www.ncbi.nlm.nih.gov/pubmed/15469582
http://dx.doi.org/10.1186/cc2943
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author Fan, Eddy
Stewart, Thomas E
author_facet Fan, Eddy
Stewart, Thomas E
author_sort Fan, Eddy
collection PubMed
description Intravascular fluid therapy is a common critical care intervention. However, the optimal type of resuscitation fluid, crystalloid or colloid, remains controversial. Despite the many theoretical benefits of human albumin administration in critically ill patients, there has been little evidence to support its widespread clinical use. Previous systematic reviews have led to conflicting results regarding the safety and efficacy of albumin. The recently reported Saline versus Albumin Evaluation study has provided conclusive evidence that 4% albumin is as safe as saline for resuscitation, although no overall benefit of albumin use was seen. Subgroup analysis of the albumin-treated group revealed a trend towards decreased mortality in patients with septic shock, and a trend towards increased mortality in trauma patients, especially those with traumatic brain injury. The results of these subgroups, as well as the use of higher albumin concentrations and other synthetic colloids (dextrans, starches), require rigorous evaluation in clinical trials. Finally, the Saline versus Albumin Evaluation trial represents a methodological milestone in critical care medicine, due to its size, its efficient trial design, and its logistical coordination. Future studies are still required, however, to establish a therapeutic niche for albumin and other colloids.
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spelling pubmed-10650312005-03-16 Albumin in critical care: SAFE, but worth its salt? Fan, Eddy Stewart, Thomas E Crit Care Commentary Intravascular fluid therapy is a common critical care intervention. However, the optimal type of resuscitation fluid, crystalloid or colloid, remains controversial. Despite the many theoretical benefits of human albumin administration in critically ill patients, there has been little evidence to support its widespread clinical use. Previous systematic reviews have led to conflicting results regarding the safety and efficacy of albumin. The recently reported Saline versus Albumin Evaluation study has provided conclusive evidence that 4% albumin is as safe as saline for resuscitation, although no overall benefit of albumin use was seen. Subgroup analysis of the albumin-treated group revealed a trend towards decreased mortality in patients with septic shock, and a trend towards increased mortality in trauma patients, especially those with traumatic brain injury. The results of these subgroups, as well as the use of higher albumin concentrations and other synthetic colloids (dextrans, starches), require rigorous evaluation in clinical trials. Finally, the Saline versus Albumin Evaluation trial represents a methodological milestone in critical care medicine, due to its size, its efficient trial design, and its logistical coordination. Future studies are still required, however, to establish a therapeutic niche for albumin and other colloids. BioMed Central 2004 2004-08-20 /pmc/articles/PMC1065031/ /pubmed/15469582 http://dx.doi.org/10.1186/cc2943 Text en Copyright © 2004 BioMed Central Ltd
spellingShingle Commentary
Fan, Eddy
Stewart, Thomas E
Albumin in critical care: SAFE, but worth its salt?
title Albumin in critical care: SAFE, but worth its salt?
title_full Albumin in critical care: SAFE, but worth its salt?
title_fullStr Albumin in critical care: SAFE, but worth its salt?
title_full_unstemmed Albumin in critical care: SAFE, but worth its salt?
title_short Albumin in critical care: SAFE, but worth its salt?
title_sort albumin in critical care: safe, but worth its salt?
topic Commentary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1065031/
https://www.ncbi.nlm.nih.gov/pubmed/15469582
http://dx.doi.org/10.1186/cc2943
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