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 facilitates fluid retention in the intravascular space. Human albumin is often given to critically ill patients with life threatening hypovolaemia. Low serum albumin concentrations are seen in various disease states and may be due to leakage, increased metabolism, or insufficient synthesis in the liver. The serum albumin concentration in critically ill patients seems to be inversely related to mortality.¹ Yet does this observation imply that hypoalbuminaemia should be treated with albumin? In this week's issue a systematic reviewpublished simultaneously in the Cochrane Library² and a sequel to a paper on the controversy of whether critically ill patients with hypovolaemia should be given colloid or crystalloid fluids³evaluates the use 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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Author's addendum to his editorial

Martin Offringa
bmj.com, 24 Jul 1998 [Full text]

Untitled

Peter McKenzie
bmj.com, 28 Jul 1998 [Full text]

Albumin;to give or not to give...

Petros Kopterides
bmj.com, 30 Jul 1998 [Full text]

Untitled

Ian J Crabb
bmj.com, 4 Aug 1998 [Full text]

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