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.
Roberts I. Cochrane injuries group albumin reviewers.
In critically ill patients, does the use of albumin compared to crystalloid for volume resuscitation increase mortality
Colloid and mortality in Cochrane.database of systematic reviews.
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.
|Outcome||CER||EER||RRR||ARR [95% CI]||NNT [95% CI]|
|Death in all patients||10%||16%||60%||6% [3% - 9%]||17 [11 - 33]|
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