1. Crit Care Med. 2011 Feb;39(2):386-91. doi: 10.1097/CCM.0b013e3181ffe217.

The role of albumin as a resuscitation fluid for patients with sepsis: a
systematic review and meta-analysis.

Delaney AP(1), Dan A, McCaffrey J, Finfer S.

Author information: 
(1)Northern Clinical School, Sydney Medical School, University of Sydney, Sydney,
Australia. adelaney@med.usyd.edu.au

Comment in
    Ann Emerg Med. 2012 May;59(5):432-3.
    Crit Care Med. 2011 Jul;39(7):1852.
    Crit Care Med. 2011 Feb;39(2):418-9.

OBJECTIVE: To assess whether resuscitation with albumin-containing solutions,
compared with other fluids, is associated with lower mortality in patients with
sepsis.
DATA SOURCES: MEDLINE, Embase, and Cochrane Central Register of Controlled Trials
databases, the metaRegister of Controlled Trials, and the Medical Editors Trial
Amnesty Register.
STUDY SELECTION: Prospective randomized clinical trials of fluid resuscitation
with albumin-containing solutions compared with other fluid resuscitation
regimens, which included a population or subgroup of participants with sepsis,
were included.
DATA EXTRACTION: Assessment of the validity of included studies and data
extraction were conducted independently by two authors.
DATA SYNTHESIS: For the primary analysis, the effect of albumin-containing
solutions on all-cause mortality was assessed by using a fixed-effect
meta-analysis.
RESULTS: Seventeen studies that randomized 1977 participants were included in the
meta-analysis. There were eight studies that included only patients with sepsis
and nine where patients with sepsis were a subgroup of the study population.
There was no evidence of heterogeneity, I² = 0%. The use of albumin for
resuscitation of patients with sepsis was associated with a reduction in
mortality with the pooled estimate of the odds ratio of 0.82 (95% confidence
limits 0.67-1.0, p = .047).
CONCLUSIONS: In this meta-analysis, the use of albumin-containing solutions for
the resuscitation of patients with sepsis was associated with lower mortality
compared with other fluid resuscitation regimens. Until the results of ongoing
randomized controlled trials are known, clinicians should consider the use of
albumin-containing solutions for the resuscitation of patients with sepsis.

DOI: 10.1097/CCM.0b013e3181ffe217 
PMID: 21248514  [Indexed for MEDLINE]