Morbidity in hospitalized patients receiving human albumin: A meta-analysis of randomized, controlled trials*

Vincent, Jean‐Louis; Navickis, Roberta J.; Wilkes, Mahlon M.

doi:10.1097/01.ccm.0000142574.00425.e9

Cited by 161 publications

(75 citation statements)

References 92 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, the superiority of colloid as compared to crystalloid solutions for resuscitation in specific groups of critically ill patients also remains a hypothesized but contentious issue. [7][8][9][10][11][12][13][14] A very large, well conducted multicentre randomized controlled trial of 6,997 heterogeneous critically ill patients in need of volume resuscitation compared 4% albumin to normal saline and found no difference in 28-day mortality between the two groups. 15 However, there was a trend towards lower mortality in a severe sepsis subgroup receiving albumin [relative risk ratio of 0.87 and 95% confidence intervals (CI) from 0.74-1.02].…”

mentioning

confidence: 99%

Resuscitating patients with early severe sepsis: A Canadian multicentre observational study

McIntyre

Fergusson

Cook

et al. 2007

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Background: Fluid resuscitation is a key factor in restoring hemodynamic stability and tissue perfusion in patients with severe sepsis. We sought to examine associations of the quantity and type of fluid administered in the first six hours after identification of severe sepsis and hospital mortality, intensive care unit (ICU) mortality, and organ failure. Methods:A retrospective, multicentre cohort study was undertaken at five Canadian tertiary care ICUs. We identified patients with severe sepsis admitted to the ICU between July 1, 2000, and June 30, 2002, using both administrative and clinical databases. Patients were included if they were hypotensive, had an infectious source, and at least two systemic inflammatory response syndrome criteria. We recorded total quantity and type of fluid administered for the first six hours after severe sepsis was identified. The first episode of hypotension defined the starting point for collection of fluid data. Multivariable regression analyses were performed to examine associations between quantity and type of fluid administered and hospital/ICU mortality, and organ failure.Results: Of 2,026 potentially eligible patient charts identified, 496 patients met eligibility criteria. The mean age and Acute Physiology and Chronic Health Evaluation score (APACHE II) were 61.8 ± 16.5 yr and 29.0 ± 8.0, respectively. No associations between quantity or type of fluid administered and hospital mortality or ICU mortality were identified, and there were no statistically significant associations between quantity or type of fluid administered and organ failure. However, more fluid resuscitation was associated with an increased risk of cardiovascular failure [odds ratio (OR) and 95% confidence interval Conclusion:An association between hospital mortality and quantity or type of fluid administered in the first six hours after the diagnosis of severe sepsis was not identifiable. These findings should be considered as hypothesis-generating and warrant confirmation or refutation by randomized controlled trials.

show abstract

mentioning

confidence: 99%

Resuscitating patients with early severe sepsis: A Canadian multicentre observational study

McIntyre

Fergusson

Cook

et al. 2007

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…There are three Cochrane analyses [10,76,113] and two systematic reviews [46,110] on the application of albumin as volume replacement during the perioperative phase, investigating the effect of albumin as compared to a crystalloid or any other colloid volume substitute. Regarding mortality neither benefit nor harm was shown when using human albumin.…”

Section: Human Albuminmentioning

confidence: 99%

“…For an assessment of using human albumin as substitute in hypovolemia or for hemodynamic stabilization of adult nonseptic intensive-care patients, the following references were incorporated in the evaluation: [14,19,24,25,28,36,56,78,81,82,93,95,104,105,109,110,112]. The meta-analyses of the Cochrane Collaboration [81,82] are referred to in the following.…”

Section: Human Albuminmentioning

confidence: 99%

Cross-Sectional Guidelines for Therapy with Blood Components and Plasma Derivatives: Chapter 5 Human Albumin - Revised

2016

Transfus Med Hemother

View full text Add to dashboard Cite

show abstract

“…Recent data have suggested that the type of resuscitation fluid used to treat hemorrhagic shock can affect the physiologic response , and that colloid versus crystalloid resuscitation in the acute trauma setting remains a controversial subject of debate. Despite the negative perception for resuscitation, recent studies showed that human albumin, as a broadly binding protein, has been characterized as a scavenger in addition to being an anti-apoptotic agent or antioxidant (Esposito et al, 1989;Emerson, 1989;Zoellner et al, 1996;Kentner et al, 2002;Osband et al, 2004b), and no increased mortality has been documented with albumin administration in the trauma population (Cochrane Injuries Group Albumin Reviewers, 1998;Vincent et al, 2004;Dubois et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Albumin resuscitation protects against traumatic/hemorrhagic shock-induced lung apoptosis in rats

Zhang

Liang

Zhang

et al. 2008

J. Zhejiang Univ. Sci. B

View full text Add to dashboard Cite

Abstract:Objective: To determine the effects of albumin administration on lung injury and apoptosis in traumatic/hemorrhagic shock (T/HS) rats. Methods: Studies were performed on an in vivo model of spontaneously breathing rats with induced T/HS; the rats were subjected to femur fracture, ischemia for 30 min, and reperfusion for 20 min with Ringer's lactate solution (RS) or 5% (w/v) albumin (ALB), and the left lower lobes of the lungs were resected. Results: Albumin administered during reperfusion markedly attenuated injury of the lung and decreased the concentration of lactic acid and the number of in situ TdT-mediated dUTP nick-end labelling (TUNEL)-positive cells. Moreover, immunohistochemistry performed 24 h after reperfusion revealed increases in the level of nuclear factor κB (NF-κB), and phosphorylated p38 mitogen-activated protein kinase (MAPK) in the albumin-untreated group was down-regulated by albumin treatment when compared with the sham rats. Conclusion: Resuscitation with albumin attenuates tissue injury and inhibits T/HS-induced apoptosis in the lung via the p38 MAPK signal transduction pathway that functions to stimulate the activation of NF-κB.

show abstract

Morbidity in hospitalized patients receiving human albumin: A meta-analysis of randomized, controlled trials*

Abstract: Albumin reduces morbidity in acutely ill hospitalized patients. Concomitant administration of albumin in the control group can obscure the effects of albumin on clinical outcome in randomized trials.

Cited by 161 publications

References 92 publications

Resuscitating patients with early severe sepsis: A Canadian multicentre observational study

Resuscitating patients with early severe sepsis: A Canadian multicentre observational study

Cross-Sectional Guidelines for Therapy with Blood Components and Plasma Derivatives: Chapter 5 Human Albumin - Revised

Albumin resuscitation protects against traumatic/hemorrhagic shock-induced lung apoptosis in rats

Contact Info

Product

Resources

About