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Impact of albumin compared to saline on organ function and mortality of patients with severe sepsis

Intensive Care Medicine, ISSN: 1432-1238, Vol: 37, Issue: 1, Page: 86-96
2011
  • 333
    Citations
  • 0
    Usage
  • 386
    Captures
  • 2
    Mentions
  • 32
    Social Media
Metric Options:   Counts1 Year3 Year

Metrics Details

  • Citations
    333
    • Citation Indexes
      320
    • Policy Citations
      8
      • Policy Citation
        8
    • Clinical Citations
      5
      • PubMed Guidelines
        5
  • Captures
    386
  • Mentions
    2
    • News Mentions
      2
      • News
        2
  • Social Media
    32
    • Shares, Likes & Comments
      32
      • Facebook
        32

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Article Description

Purpose: To determine the effect of random assignment to fluid resuscitation with albumin or saline on organ function and mortality in patients with severe sepsis. Methods: Pre-defined subgroup analysis of a randomized controlled trial conducted in the intensive care units of 16 hospitals in Australia and New Zealand. Results: Of 1,218 patients with severe sepsis at baseline, 603 and 615 were assigned to receive albumin and saline, respectively. The two groups had similar baseline characteristics. During the first 7 days mean arterial pressure was similar in the two groups, but patients assigned albumin had a lower heart rate on days 1 and 3 (p = 0.002 and p = 0.03, respectively) and a higher central venous pressure on days 1–3 (p <0.005 each day). There was no difference in the renal or total Sequential Organ Failure Assessment score of the two groups; 113/603 (18.7%) of patients assigned albumin were treated with renal replacement therapy compared to 112/615 (18.2%) assigned saline (p = 0.98).The unadjusted relative risk of death for albumin versus saline was 0.87 [95% confidence interval (CI) 0.74–1.02] for patients with severe sepsis and 1.05 (0.94–1.17) for patients without severe sepsis (p = 0.06 for heterogeneity). From multivariate logistic regression analysis adjusting for baseline factors in patients with complete baseline data (919/1,218, 75.5%), the adjusted odds ratio for death for albumin versus saline was 0.71 (95% CI: 0.52–0.97; p = 0.03). Conclusions: Administration of albumin compared to saline did not impair renal or other organ function and may have decreased the risk of death.

Bibliographic Details

Simon Finfer; Suzanne McEvoy; Rinaldo Bellomo; Colin McArthur; John Myburgh; Robyn Norton; Julie French; Gordon Doig; Mary Hayek; Sheridan O’Donnell; Anthony Bell; Neil Boyce; David Blythe; John Cade; Marianne Chapman; Louise Cole; D. James Cooper; Andrew Davies; Craig French; Christopher Joyce; Stephen MacMahon; Bruce Neal; Jeffrey Presneill; Peter Saul; Ian Seppelt; Dianne Stephens; Andrew Turner; Anthony Williams; Clive Woolfe; Richard Peto; Peter Sandercock; Charles Sprung; J. Duncan Young; Laurent Billot; Michael Fitzharris; Qiang Li; Julie Charlton; Catherine Harry; Lisa Higgins; Katherine Moulden; Shirley Vallance; Janine Chadderton; Lynette Newby; Samantha Bates; Donna Goldsmith; Alison Voss; Annamaria Palermo; Lesley Francis; Kathy Jayne; Mamta Merai; Sameer Pandey; Manuela Schmidt; Siva Sivarajasingham; Mark Woodward; Rosemary Carroll; Brett McFadyen; Jane Clarke; Juliet Powell; Judi Tai; Iveta Hynesova; Leonie Weisbrodt; Lisa Bradley; Theresa Kelly; Anthony Limpus; Robyn Moore; Stephanie Creed; Sandra Kaplan; Justine Rivett; Jane Thomas; Kathy Marsden; Catherine Boyce; Belinda Howe; Megan Robertson; Anne O’Connor; Julie Potter; Naresh Ramakrishnan; Catherine Powell; Dorrilyn Rajbhandari; Kathryn Girling; Marie Hodgetts; Alina Jovanovska; Lorraine Little

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