Hypovolemia: Albumin increases mortality in critically ill patients
Clinical Bottom Line
In critically ill patients, the use of albumin compared to crystalloid for volume resuscitation is associated with increased mortality.
Citation
Roberts I. Cochrane injuries group albumin reviewers.
BMJ 1998;317:235-240.
Clinical Question
In critically ill patients, does the use of albumin compared to crystalloid for volume resuscitation increase mortality
Search Terms
Colloid and mortality in Cochrane.database of systematic reviews.
The Study
A systematic review of randomized clinical trials that evaluated whether the use of albumin compared with crystalloid for volume resuscitation is associated with mortality in critically ill patients.
The Evidence
| Outcome | CER | EER | RRR | ARR [95% CI] | NNT [95% CI] |
|---|---|---|---|---|---|
| Death in all patients | 10% | 16% | 60% | 6% [3% - 9%] | 17 [11 - 33] |
Comments
-
The association between use of albumin and mortality was consistent across the subgroups analyzed:
- Hypovolemia RR of death with albumin: 1.46 (95% CI 0.97-2.22)
- Burns RR of death with albumin: 2.40 (95% CI 1.11 - 5.19)
- Hypoalbuminemia RR of death with albumin: 1.69 (95% CI 1.07-2.67)
- Many of the studies included in the analysis had weak methods. Most did not use blinded outcome assessment and most did not describe timing of the intervention of co-interventions. Nevertheless, none of the data suggest that the use of albumin is beneficial
Appraised By
Pronovost 1999
Expiry Date
2000