Randomised controlled trial of albumin infusion in ill preterm infants

Abstract

We assessed the effect of albumin infusion on weight loss and ventilation requirement in sick premature infants. Thirty infants, median gestational age 29 weeks, were entered into a randomised controlled trial, at a median of 2 days of age. The infants, all with an albumin level < or = 30 g/l, received either 5 ml/kg of 20% albumin or 5 ml/kg of their maintenance fluids (placebo), both given as part of the total daily fluid requirement. The response to the infusion was assessed by comparing two periods; 12 h immediately prior to the infusion and 12-24 h after the infusion. Albumin infusion was associated with a significant increase in albumin level and a significant reduction in weight, but in the placebo group there was a significant increase in weight. There were, however, no significant changes in the peak inspiratory pressure in response to either infusion. There was only a modest reduction (< 15%) in the inspired oxygen concentration, which occurred in both groups, but reached statistical significance only following the albumin infusion. We conclude that our results suggest that albumin infusion in "hypoalbuminaemic" sick preterm infants is unlikely to alter their respiratory status.

Albumin infusion for low serum albumin in preterm newborn infants

“…there were insufficient or no data to assess other clinically important outcomes). The study by Greenough et al (Greenough 1993) did not to report any of our primary and secondary outcome measures.…”

“…Greenough et al (Greenough 1993) studied the effect of albumin infusion versus placebo on 40 premature infants (28 -34 weeks gestational age, 20 in each group). Study subjects were newborn infants who were ventilator dependant at less than seven days of age and had a serum albumin level of ≤30 g/L.…”

Albumin versus normal saline for dehydrated term infants with metabolic acidosis due to acute diarrhea

“…15 By contrast, the infusion of colloidal fluid during the perinatal period in premature infants of median gestational age 27 weeks has been related to an increased duration of oxygen dependency and abnormal neurodevelopmental outcomes. 16,17 In addition, albumin potentially causes deterioration of the protein leak syndrome of prematurity and lung function by deactivation of the surfactant in alveolar spaces.…”

Randomized Trial of Volume Infusion During Resuscitation of Asphyxiated Neonatal Piglets

“…ALB-containing solutions are not part of the recommendations because of increased cost, limited availability, a theoretical risk of infectious disease, and in particular a previous observed association with increase mortality in a large meta-analysis of ALB versus crystalloid use across the indications of hypovolemia, burns, and hypoalbuminemia of primarily adult studies (3). Two neonatal trials of hypotensive preterm infants in the neonatal intensive care unit (8,9) were included along with 28 adult trials. Several of the included adult studies suggested that patients who received ALB had worse pulmonary outcomes (10 -12).…”