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The evidence for small-volume resuscitation with hyperoncotic albumin in critical illness

Small-volume resuscitation of critically ill patients with hyperoncotic albumin offers a number of theoretical advantages, such as increasing intravascular volume in excess of the volume of fluid administered and reducing interstitial edema. Whilst iso-oncotic albumin has been shown to be equi-effec...

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Autor principal: Myburgh, John A
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2447614/
https://www.ncbi.nlm.nih.gov/pubmed/18492216
http://dx.doi.org/10.1186/cc6882
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author Myburgh, John A
author_facet Myburgh, John A
author_sort Myburgh, John A
collection PubMed
description Small-volume resuscitation of critically ill patients with hyperoncotic albumin offers a number of theoretical advantages, such as increasing intravascular volume in excess of the volume of fluid administered and reducing interstitial edema. Whilst iso-oncotic albumin has been shown to be equi-effective to isotonic saline for the resuscitation of critically ill patients without associated traumatic brain injury, the efficacy of hyperoncotic albumin for resuscitation has not been evaluated in large-scale randomized-controlled trials. Overall, the evidence for resuscitation with hyper-oncotic albumin is limited by studies of poor methodological quality with heterogenous study populations and control regimens. There is marginal qualitative evidence of improvements in surrogate outcomes in disparate patient populations, but no evidence of any survival benefit associated with resuscitation with hyperoncotic albumin. Given the lack of evidence and clinical uncertainty about the efficacy of hyperoncotic albumin, a large-scale randomized-controlled trial is required to determine its role in the acute resuscitation of hypovolemic or hypoalbuminemic critically ill patients.
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spelling pubmed-24476142008-07-10 The evidence for small-volume resuscitation with hyperoncotic albumin in critical illness Myburgh, John A Crit Care Commentary Small-volume resuscitation of critically ill patients with hyperoncotic albumin offers a number of theoretical advantages, such as increasing intravascular volume in excess of the volume of fluid administered and reducing interstitial edema. Whilst iso-oncotic albumin has been shown to be equi-effective to isotonic saline for the resuscitation of critically ill patients without associated traumatic brain injury, the efficacy of hyperoncotic albumin for resuscitation has not been evaluated in large-scale randomized-controlled trials. Overall, the evidence for resuscitation with hyper-oncotic albumin is limited by studies of poor methodological quality with heterogenous study populations and control regimens. There is marginal qualitative evidence of improvements in surrogate outcomes in disparate patient populations, but no evidence of any survival benefit associated with resuscitation with hyperoncotic albumin. Given the lack of evidence and clinical uncertainty about the efficacy of hyperoncotic albumin, a large-scale randomized-controlled trial is required to determine its role in the acute resuscitation of hypovolemic or hypoalbuminemic critically ill patients. BioMed Central 2008 2008-04-30 /pmc/articles/PMC2447614/ /pubmed/18492216 http://dx.doi.org/10.1186/cc6882 Text en Copyright © 2008 BioMed Central Ltd
spellingShingle Commentary
Myburgh, John A
The evidence for small-volume resuscitation with hyperoncotic albumin in critical illness
title The evidence for small-volume resuscitation with hyperoncotic albumin in critical illness
title_full The evidence for small-volume resuscitation with hyperoncotic albumin in critical illness
title_fullStr The evidence for small-volume resuscitation with hyperoncotic albumin in critical illness
title_full_unstemmed The evidence for small-volume resuscitation with hyperoncotic albumin in critical illness
title_short The evidence for small-volume resuscitation with hyperoncotic albumin in critical illness
title_sort evidence for small-volume resuscitation with hyperoncotic albumin in critical illness
topic Commentary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2447614/
https://www.ncbi.nlm.nih.gov/pubmed/18492216
http://dx.doi.org/10.1186/cc6882
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