| Human albumin administration in critically ill patients: systematic review of randomised controlled trials. Cochrane Injuries Group Albumin Reviewers. | |
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MedLine Citation:
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PMID: 9677209 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To quantify effect on mortality of administering human albumin or plasma protein fraction during management of critically ill patients. DESIGN: Systematic review of randomised controlled trials comparing administration of albumin or plasma protein fraction with no administration or with administration of crystalloid solution in critically ill patients with hypovolaemia, burns, or hypoalbuminaemia. SUBJECTS: 30 randomised controlled trials including 1419 randomised patients. MAIN OUTCOME MEASURE: Mortality from all causes at end of follow up for each trial. RESULTS: For each patient category the risk of death in the albumin treated group was higher than in the comparison group. For hypovolaemia the relative risk of death after albumin administration was 1.46 (95% confidence interval 0.97 to 2.22), for burns the relative risk was 2.40 (1.11 to 5.19), and for hypoalbuminaemia it was 1.69 (1.07 to 2.67). Pooled relative risk of death with albumin administration was 1.68 (1.26 to 2.23). Pooled difference in the risk of death with albumin was 6% (95% confidence interval 3% to 9%) with a fixed effects model. These data suggest that for every 17 critically ill patients treated with albumin there is one additional death. CONCLUSIONS: There is no evidence that albumin administration reduces mortality in critically ill patients with hypovolaemia, burns, or hypoalbuminaemia and a strong suggestion that it may increase mortality. These data suggest that use of human albumin in critically ill patients should be urgently reviewed and that it should not be used outside the context of rigorously conducted, randomised controlled trials. |
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Authors:
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Publication Detail:
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Type: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: BMJ (Clinical research ed.) Volume: 317 ISSN: 0959-8138 ISO Abbreviation: BMJ Publication Date: 1998 Jul |
Date Detail:
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Created Date: 1998-09-03 Completed Date: 1998-09-03 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 8900488 Medline TA: BMJ Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 235-40 Citation Subset: AIM; IM |
Affiliation:
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Cochrane Injuries Group, Department of Epidemiology and Public Health, Institute of Child Health, London WC1N 1EH. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Albumins
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adverse effects* Blood Proteins / adverse effects Burns / drug therapy, mortality Colloids / adverse effects Critical Illness / mortality* Crystallization Humans Randomized Controlled Trials as Topic Risk Factors Serum Albumin / deficiency Shock / drug therapy, mortality |
| Chemical | |
Reg. No./Substance:
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0/Albumins; 0/Blood Proteins; 0/Colloids; 0/Serum Albumin |
| Comments/Corrections | |
Comment In:
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BMJ. 1999 Apr 24;318(7191):1144
[PMID:
10366270
]
BMJ. 1999 May 1;318(7192):1215 [PMID: 10383208 ] BMJ. 1999 May 1;318(7192):1214-5 [PMID: 10221965 ] BMJ. 1999 Feb 13;318(7181):464 [PMID: 9974474 ] BMJ. 1999 Feb 13;318(7181):464 [PMID: 10084840 ] BMJ. 1998 Sep 26;317(7162):884 [PMID: 9786699 ] BMJ. 1998 Sep 26;317(7162):884 [PMID: 9786698 ] BMJ. 1998 Sep 26;317(7162):883-4 [PMID: 9786697 ] BMJ. 1998 Sep 26;317(7162):883 [PMID: 9786695 ] BMJ. 1998 Sep 26;317(7162):882-3 [PMID: 9786694 ] BMJ. 1998 Sep 26;317(7162):882 [PMID: 9748194 ] BMJ. 1998 Sep 26;317(7162):882 [PMID: 9786693 ] BMJ. 1998 Sep 26;317(7162):829-30 [PMID: 9748170 ] BMJ. 2005 Jan 15;330(7483):145; author reply 146 [PMID: 15649932 ] BMJ. 1998 Sep 26;317(7162):885 [PMID: 9786702 ] BMJ. 1998 Sep 26;317(7162):883 [PMID: 9786696 ] ACP J Club. 1999 Jan-Feb;130(1):6 BMJ. 1998 Aug 1;317(7154):343 [PMID: 9685288 ] BMJ. 1998 Jul 25;317(7153):240 [PMID: 9677210 ] BMJ. 1998 Jul 25;317(7153):223-4 [PMID: 9677204 ] BMJ. 1998 Sep 26;317(7162):885-6 [PMID: 9786703 ] BMJ. 2003 Mar 15;326(7389):559-60 [PMID: 12637372 ] BMJ. 1998 Sep 26;317(7162):884-5 [PMID: 9786700 ] BMJ. 1998 Sep 26;317(7162):885 [PMID: 9786701 ] |
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