Document Detail


Human albumin administration in critically ill patients: systematic review of randomised controlled trials.
MedLine Citation:
PMID:  9677209     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Related Documents :
1915479 - Caustic burns of the upper digestive and respiratory tracts.
9295829 - Dramatic effect on oxygenation in patients with severe acute lung insufficiency treated...
18695609 - Thigh burn associated with laptop computer use.
9882069 - The comparison of early fluid therapy in extensive flame burns between inhalation and n...
21614669 - Prolonged toxicity after amitriptyline overdose in a patient deficient in cyp2d6 activity.
6587799 - Effect of supplemental oxygen on transcutaneous po2 of patients undergoing surgical rem...
18468459 - Does the seizure frequency increase in ramadan?
24718489 - Vitamin d status of patients with early inflammatory arthritis.
9052099 - Removal from stimuli for crisis intervention: using least restrictive methods to improv...
Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  BMJ (Clinical research ed.)     Volume:  317     ISSN:  0959-8138     ISO Abbreviation:  BMJ     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-09-03     Completed Date:  1998-09-03     Revised Date:  2013-09-27    
Medline Journal Info:
Nlm Unique ID:  8900488     Medline TA:  BMJ     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  235-40     Citation Subset:  AIM; IM    
Affiliation:
Cochrane Injuries Group, Department of Epidemiology and Public Health, Institute of Child Health, London WC1N 1EH.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Albumins / 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:
0/Albumins; 0/Blood Proteins; 0/Colloids; 0/Serum Albumin
Comments/Corrections
Comment In:
BMJ. 2005 Jan 15;330(7483):145; author reply 146   [PMID:  15649932 ]
BMJ. 2003 Mar 15;326(7389):559-60   [PMID:  12637372 ]
BMJ. 1998 Sep 26;317(7162):882   [PMID:  9786693 ]
BMJ. 1998 Sep 26;317(7162):882   [PMID:  9748194 ]
BMJ. 1998 Sep 26;317(7162):882-3   [PMID:  9786694 ]
BMJ. 1998 Sep 26;317(7162):883   [PMID:  9786695 ]
BMJ. 1998 Sep 26;317(7162):883-4   [PMID:  9786697 ]
BMJ. 1998 Sep 26;317(7162):884   [PMID:  9786698 ]
BMJ. 1998 Sep 26;317(7162):884   [PMID:  9786699 ]
BMJ. 1998 Sep 26;317(7162):884-5   [PMID:  9786700 ]
BMJ. 1998 Sep 26;317(7162):885   [PMID:  9786701 ]
BMJ. 1998 Sep 26;317(7162):885-6   [PMID:  9786703 ]
BMJ. 1998 Jul 25;317(7153):223-4   [PMID:  9677204 ]
BMJ. 1998 Jul 25;317(7153):240   [PMID:  9677210 ]
BMJ. 1998 Aug 1;317(7154):343   [PMID:  9685288 ]
ACP J Club. 1999 Jan-Feb;130(1):6
BMJ. 1998 Sep 26;317(7162):883   [PMID:  9786696 ]
BMJ. 1998 Sep 26;317(7162):885   [PMID:  9786702 ]
BMJ. 1999 Feb 13;318(7181):464   [PMID:  10084840 ]
BMJ. 1999 Feb 13;318(7181):464   [PMID:  9974474 ]
BMJ. 1999 May 1;318(7192):1214-5   [PMID:  10221965 ]
BMJ. 1999 May 1;318(7192):1215   [PMID:  10383208 ]
BMJ. 1999 Apr 24;318(7191):1144   [PMID:  10366270 ]
BMJ. 1998 Sep 26;317(7162):829-30   [PMID:  9748170 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Inactivation of a serotonin-gated ion channel by a polypeptide toxin from marine snails.
Next Document:  Reduced fetal growth rate and increased risk of death from ischaemic heart disease: cohort study of ...