Albumin Supplementation in Sepsis Patients

Greg Martin, MD


April 14, 2014


Albumin Replacement in Patients With Severe Sepsis or Septic Shock

Caironi P, Tognoni G, Masson S, et al; ALBIOS Study Investigators
N Engl J Med. 2014 Mar 18. [Epub ahead of print]

Fluid administration is one of the most common items managed every day in hospitalized and intensive care unit (ICU) patients. The optimal fluid for sepsis resuscitation remains unknown, with concerns about both crystalloids and colloids.[1]

Caironi and colleagues sought to examine whether albumin supplementation would benefit patients with severe sepsis and septic shock. This study randomly assigned 1818 of these patients within 24 hours of ICU admission to receive either crystalloids or crystalloids plus albumin supplementation, to maintain a serum albumin level of 3 g/dL.

Early in the course, albumin-treated patients had at least intermittently higher central venous pressure, higher mean arterial pressure, and less positive fluid balance. There was no difference in mortality at 28 days or 90 days, although the subset of patients with septic shock treated with albumin did have a lower mortality at 90 days (43.6% vs 49.9%; P = .03).


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