Excess mortality after human albumin administration in critically ill patients

BMJ 1998;317:223-224 ( 25 July )

Editorials

Excess mortality after human albumin administration in critically ill patients

Clinical and pathophysiological evidence suggests albumin is harmful

Papers p 235 Letters p 277 Science commentary p 240

The first 150 words of the full text of this article appear below.

Albumin is a medium weight colloid which plays an essential role in generating the colloid-osmotic pressure. It facilitatesfluid retention in the intravascular space. Human albumin is oftengiven to critically ill patients with life threatening hypovolaemia.Low serum albumin concentrations are seen in various disease statesand may be due to leakage, increased metabolism, or insufficientsynthesis in the liver. The serum albumin concentration in criticallyill patients seems to be inversely related to mortality.¹ Yetdoes this observation imply that hypoalbuminaemia should be treatedwith albumin? In this week's issue a systematic review $---$ publishedsimultaneously in the Cochrane Library² and a sequel to a paperon the controversy of whether critically ill patients with hypovolaemiashould be given colloid or crystalloid fluids³ $---$ evaluates theuse of human albumin in various clinical settings (p 235).⁴

The paper is clinically important because it suggests that a respected and widely used . . . [Full text of this article]

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