ISICEM: Albumin Does Not Improve Survival in Sepsis
No difference in 28-day, 90-day mortality with addition of albumin to crystalloid solution
WEDNESDAY, March 19, 2014 (HealthDay News) -- For patients with severe sepsis in intensive care units, the use of albumin replacement in addition to crystalloid solution does not improve survival, according to a study published online March 18 in the New England Journal of Medicine. This research was published to coincide with the International Symposium on Intensive Care and Emergency Medicine, held from March 18 to 21 in Brussels.
Pietro Caironi, M.D., Ph.D., from the Università degli Studi di Milano, and colleagues randomized 1,818 patients with severe sepsis in 100 intensive care units to receive 20 percent albumin and crystalloid solution or crystalloid solution alone.
The researchers found that, compared with those in the crystalloid group, patients in the albumin group had a higher mean arterial pressure (P = 0.03) and lower net fluid balance (P < 0.001) during the first seven days. There was no significant between-group difference in the total daily amount of administered fluid (P = 0.10). At 28 days, 31.8 percent of the albumin group and 32.0 percent of the crystalloid group had died (relative risk in albumin group, 1.00; P = 0.94). Mortality at 90 days was 41.1 and 43.6 percent, respectively (relative risk, 0.94; P = 0.29).
"In patients with severe sepsis, albumin replacement in addition to crystalloids, as compared with crystalloids alone, did not improve the rate of survival at 28 and 90 days," the authors write.
The study was funded by the Italian Medicines Agency.