Human albumin administration in critically ill patients

Petros, A. J.; Schindler, Margrid; Pierce, Christine; Jacobe, Stephen; Mok, Quen; Nel, M. R; Nadel, Simon; Marriage, S.; Munter, Claudine De; Britto, Jonathan A.; Habibi, Parviz; Levin, Michael; Kaag, M.; Zoetmulder, F.A.N.; Riordan, F. A. I.; Williams, A.; Thomson, A. P. J.; Soni, Neelam; Goodman, N. W; Beale, R J; Wyncoll, D. L. A.; McLuckie, A; Frame, J D; Moiemem, N; Chalmers, Iain; Lawler, P G; Morgan, Gabrielle; Shwe, K H; Bhavnani, M.; Roberts, Irene

doi:10.1136/bmj.317.7162.882

Cited by 31 publications

(10 citation statements)

References 5 publications

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“…This report has sparked considerable debate among paediatric anaesthetists since the report also included four neonatal studies, showing a similar trend for less favourable outcome associated with the use of albumin infusions. This report from the Cochrane library has been criticized for a number of reasons (2–5), including comments from paediatric intensivists (6), and no consensus has so far been reached regarding this important topic in the paediatric anaesthesia community.…”

Section: Introductionmentioning

confidence: 99%

Use of albumin, blood transfusion and intraoperative glucose by APA and ADARPEF members: a postal survey

Söderlind

Salvignol

Izard

et al. 2001

Pediatric Anesthesia

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The response rate of the survey was 38% and 25% for APA and ADARPEF members, respectively. Forty-one percent of APA members reported a reduced use of albumin containing solutions following the publication of the Cochrane report compared to eight percent in the ADARPEF group (P < 0.0001). Albumin continues to be the most frequently used plasma expander in premature babies and neonates, whereas many colleagues use alternative colloids in infants and older children. A clear difference was observed in the 1-12-year-old age group between APA members favouring the use of gelatines and ADARPEF members who instead frequently use hetastarch solutions. ADARPEF members appeared to have a slightly more restrictive attitude towards blood transfusion and also reported more widespread use of erythropoetin (56% versus 9%, P < 0.0001) and predilution techniques (40% versus 23%, P < 0.04) compared with APA members. Regarding intraoperative maintenance solutions, a large proportion of both APA and ADARPEF members still use high concentrations of glucose intraoperatively, even in older children.

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Section: Introductionmentioning

confidence: 99%

Use of albumin, blood transfusion and intraoperative glucose by APA and ADARPEF members: a postal survey

Söderlind

Salvignol

Izard

et al. 2001

Pediatric Anesthesia

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“…33,35 The publication of the CIGAR systematic review unleashed a storm of controversy. An article in The Times newspaper suggested that up to 30,000 patients in Britain might have died as a result of receiving HAS, 36 doctors were faced with concerns from patients and relatives about 'the killer fluid', 37 and Ian Chalmers, director of the Cochrane Centre, openly stated that he would attempt to sue anyone who gave him an infusion of albumin. 38 Despite a series of 'incandescent letters' in the medical press attacking the study's findings and defending current practice, 39 many clinicians believed the review made the on-going employment of HAS 'legally indefensible'.…”

mentioning

confidence: 99%

“…38 Despite a series of 'incandescent letters' in the medical press attacking the study's findings and defending current practice, 39 many clinicians believed the review made the on-going employment of HAS 'legally indefensible'. 37 By the end of 1998, demand for albumin had fallen by 40% in the United Kingdom. 40 This unsatisfactory situation was ultimately resolved by the Saline versus Albumin Fluid Evaluation (SAFE) study, conducted by the Australian and New Zealand Intensive Care Society Clinical Trials Group, the Australian Red Cross Blood Service, and the George Institute for International Health, between November 2001 and June 2003.…”

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confidence: 99%

From conflict to controversy: the use and abuse of human albumin solutions after the Second World War

Featherstone,

Ball

2023

Anaesth Intensive Care

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“…In 1998, the Cochrane Injuries Group Albumin Reviewers [25] conducted a meta-analysis of albumin use in critically ill patients, which surprisingly demonstrated heightened mortality in patients administered albumin compared to those who received no albumin or crystalloid therapy. These findings were not corroborated by a subsequent analysis [26] and have been questioned due to the heterogeneity of the interventions (iso-oncotic albumin for resuscitation versus hyper-oncotic albumin for supplementation), disparate patient populations, and the small sample sizes of the included trials.…”

Section: Fluid Typesmentioning

confidence: 99%

Fluid Management for Critically Ill Patients: A Review of the Current State of Fluid Therapy in the Intensive Care Unit

Frazee¹,

Kashani

2016

Kidney Dis

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Background: Intravenous fluids (IVF) are frequently utilized to restore intravascular volume in patients with distributive and hypovolemic shock. Although the benefits of the appropriate use of fluids in intensive care units (ICUs) and hospitals are well described, there is growing knowledge regarding the potential risks of volume overload and its impact on organ failure and mortality. To avoid volume overload and its associated complications, strategies to identify fluid responsiveness are developed and utilized more often among ICU patients. Apart from the amount of fluid utilized for resuscitation, the type of fluid used also impacts patient outcome. Colloids and crystalloids are two types of fluids that are utilized for resuscitation. The efficacy of each fluid type on the expansion of intravascular volume on one hand and the potential adverse effects of each individual fluid, on the other hand, need to be considered when choosing the type of fluid for resuscitation. The negative impact of hydroxyethyl starch on kidney function, of albumin on the mortality of head trauma patients and chloride-rich crystalloids on mortality and kidney function, are only examples of new developments in the field. Summary: In this paper, we will review the impact of fluid overload on patient outcomes, define the fluid challenge, describe the differences in static and dynamic estimates of fluid responsiveness, and review the effect of different types of fluid on patient outcome. Key Message: Avoiding fluid overload by choosing the appropriate amount of fluids in patients who are fluid-responsive on one hand, and treating IVF like other medications, on the other hand, are the major changes. Whenever clinicians decide to prescribe IVF, they need to weigh the risks and benefits of giving fluid and also the advantages and side effects of each fluid type in order to optimize patient outcomes.

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Human albumin administration in critically ill patients

Cited by 31 publications

References 5 publications

Use of albumin, blood transfusion and intraoperative glucose by APA and ADARPEF members: a postal survey

Use of albumin, blood transfusion and intraoperative glucose by APA and ADARPEF members: a postal survey

From conflict to controversy: the use and abuse of human albumin solutions after the Second World War

Fluid Management for Critically Ill Patients: A Review of the Current State of Fluid Therapy in the Intensive Care Unit

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