Albumi Use ICU

Robert
I

Human
Albumin Administration in Critically Ill Patients :
Systematic Review of Randomized Controlled Trials

BMJ
317: 235-240, 1998

  

The
risk of death increases inversely with the decrease in
serum albumin in critically ill patients. 
Because human albumin is very expensive compared
with other colloid solutions, its use should be limited
to those who can benefit. A systematic review of
randomized, controlled trials was conducted to quantify
the effects on mortality of critically ill patients with
hypovolemia and hypoprotenemia.

   

Thirty
randomized trials, involving 1419 patients, were
identified.  Patients were categorized by type of injury and intervention. 
Mortality from all causes was tallied

   

After
administration of albumin, the relative risks of death
from hypovolemia, burns, and hypoalbuminemia were 1.46,
2.40 and 1.69 respectively. 
The pooled risk of death was 1.68. 
The pooled difference in the risk of death after
albumin administration was 6 deaths for every 100
patients treated.

   

It
was observed albumin administration did not decrease
mortality and may, indeed, increase mortality in
critically ill patients with hypovolemia, burns, and
hypoalbuminemia.  The
practice of administering human albumin to critically
ill patients should be reviewed.