Impact of albumin compared to saline on organ function and mortality of patients with severe sepsis

Finfer, Simon; McEvoy, Suzanne; Bellomo, Rinaldo; McArthur, Colin; Myburgh, John; Norton, Robyn

doi:10.1007/s00134-010-2039-6

Cited by 300 publications

(133 citation statements)

References 32 publications

(23 reference statements)

Supporting

Mentioning

124

Contrasting

Unclassified

Order By: Relevance

“…Among these studies, only the SAFE (Saline Versus Albumin Fluid Evaluation) 2011 study140 was identified as an applicable RCT. No significant difference between the mortality risk ratio of 0.87 (95% CI: 0.74–1.02) and ICU length of stay of 0.7 (95% CI: −0.10 to 1.50) was observed.…”

Section: Cq7: Initial Resuscitation/inotropesmentioning

confidence: 99%

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Nishida

Ogura

Egi

et al. 2018

Acute Medicine & Surgery

157

View full text Add to dashboard Cite

Background and PurposeThe Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016), a Japanese‐specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 in Japanese. An English‐language version of these guidelines was created based on the contents of the original Japanese‐language version.MethodsMembers of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ), and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two‐thirds (>66.6%) majority vote of each of the 19 committee members.ResultsA total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J‐SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation and its supporting evidence were also added to each recommendation statement. We conducted meta‐analyses for 29 CQs. Thirty seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for 5 CQs.ConclusionsBased on the evidence gathered, we were able to formulate Japanese‐specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non‐specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals.

show abstract

Section: Cq7: Initial Resuscitation/inotropesmentioning

confidence: 99%

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Nishida

Ogura

Egi

et al. 2018

Acute Medicine & Surgery

157

View full text Add to dashboard Cite

show abstract

“…While there is little evidence to support the use of colloids over crystalloids in sepsis, there are some data to suggest that albumin, used both as a resuscitation fluid [56], or to maintain a serum albumin above 30 g/L [57], may be associated with improved outcome. These results have to be confirmed as they were obtained in secondary analyses.…”

Section: Fluidsmentioning

confidence: 99%

Sepsis: frontiers in diagnosis, resuscitation and antibiotic therapy

et al. 2016

View full text Add to dashboard Cite

Sepsis is a major growing global burden and a major challenge to intensive care clinicians, researchers, guideline committee members and policy makers, because of its high and increasing incidence and great pathophysiological, molecular, genetic and clinical complexity. In spite of recent progress short term mortality remains high and there is growing evidence of long term morbidity and increased long term mortality in survivors of sepsis both in developed and developing countries. Further improvement in the care of patients with sepsis will impact upon global health.In this narrative review, invited experts describe the expected challenges and progress to be made in the near future. We focus on resuscitation (fluids, vasopressors, inotropes, blood transfusion and hemodynamic targets) and infection control (antibiotics and infection biomarkers) as these areas are key, if initial management and subsequent outcomes are to be improved in patients with sepsis.

show abstract

“…The randomized PICNIC study is currently evaluating the impact of nutritional intervention on morbidity and mortality in malnourished hospitalized HF patients with and without hypoalbuminemia 34. Whether albumin administration in patients with HF would likely be beneficial as in sepsis, brain trauma, or lung injury is unknown 35, 36, 37, 38. In these conditions, the use of albumin is likely necessary to expand the volume and maintain the circulation.…”

Section: Discussionmentioning

confidence: 99%

Serum albumin level and hospital mortality in acute non‐ischemic heart failure

et al. 2017

View full text Add to dashboard Cite

AimsHypoalbuminemia is common in heart failure (HF), especially in elderly patients. It is associated with an increased risk of death. The present study sought to examine the prognostic significance of serum albumin level in the prediction of hospital mortality in patients admitted for acute non‐ischemic HF.Methods and resultsWe examined the association between albumin and hospital mortality in a cohort of 546 patients admitted for acute non‐ischemic HF. None of the patients had infectious disease, severe arrhythmias (atrial fibrillation, ventricular tachycardia, ventricular fibrillation), required invasive ventilation, or presented with acute coronary syndrome or primary valvular disease. Thirty‐six patients (7%) died during the hospital stay. These patients were significantly older (78 ± 9 vs. 72 ± 12 years; P = 0.006), had higher heart rate (P < 0.0001), increased creatinine level (P = 0.01), lower systolic and diastolic blood pressures (P < 0.05), elevated leucocyte count (P = 0.001), and lower albumin levels (31.3 ± 5.6 g/L vs. 36.9 ± 4.1 g/L; P < 0.001). With multivariable analysis, age (P = 0.01), heart rate (P < 0.0003), diastolic blood pressure (P < 0.01), leukocyte count (P = 0.009), and serum albumin level (P < 0.0001) emerged as independent predictors of hospital mortality. Hypoalbuminemia (<34 g/L) yielded the best sensitivity (78.8%) and specificity (75%) for predicting hospital death.ConclusionsSerum albumin level measured at admission can serve as a simple prognostic factor in acute non‐ischemic HF. Hypoalbuminemia is associated with increased risk of hospital mortality, especially in elderly patients.

show abstract

Impact of albumin compared to saline on organ function and mortality of patients with severe sepsis

Abstract: Administration of albumin compared to saline did not impair renal or other organ function and may have decreased the risk of death.

Cited by 300 publications

References 32 publications

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Sepsis: frontiers in diagnosis, resuscitation and antibiotic therapy

Serum albumin level and hospital mortality in acute non‐ischemic heart failure

Contact Info

Product

Resources

About