Albumin controversy continues

BMJ 1999;318:464 ( 13 February )

Letters

Albumin controversy continues

Meta-analysis has affected use of albumin

Lack of efficacy shows that treatments do not work

Meta-analysis has affected use of albumin

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

EDITOR $---$ With the recent Cochrane Injuries Group meta-analysis regarding albumin¹ and subsequent correspondence in mind,we undertook a postal survey of paediatric departments in theSouth East Thames region. We asked clinicians which fluid (crystalloid,albumin, or other colloid) would be used in a variety of scenarios,before and after 25 July 1998, in light of the meta-analysis.Altogether 12 of 13 departments replied, which equals a 92% responserate (table).

Table Removed (Available Only in the Full Text)

We found that all 12 would use crystalloid for 5% dehydration after gastroenteritis, both before and after 25 July. Crystalloidsare favoured over "other colloids" for all indications. Recentpublications have influenced routine clinical practice, reducingclinicians' willingness to use albumin, but most departments havenot made changes. Only in trauma resuscitation has there beena substantial shift away from albumin to crystalloid, and in meningococcaldisease clinicians are still regularly using albumin. This suggeststhat published reservations² regarding the meta-analysis areborne out . . . [Full text of this article]

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Article

Human albumin administration in critically ill patients: systematic review of randomised controlled trials • Why albumin may not work: Cochrane Injuries Group Albumin Reviewers and Cochrane Injuries Group Albumin Reviewers
BMJ 1998 317: 235-240. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

Matejtschuk, P., Dash, C. H., Gascoigne, E. W. (2000). Production of human albumin solution: a continually developing colloid. Br J Anaesth 85: 887-895 [Abstract] [Full text]
Skellett, S, Mayer, A, Durward, A, Tibby, S M, Murdoch, I A (2000). Chasing the base deficit: hyperchloraemic acidosis following 0.9% saline fluid resuscitation. Arch. Dis. Child. 83: 514-516 [Abstract] [Full text]
Murray, G. D, Teasdale, G. M, Roberts, I., Bunn, F., Wentz, R., Edwards, P., Smith, R. (2000). Quality of randomised controlled trials in head injury. BMJ 321: 1223-1223 [Full text]
Novack, G. D. (1999). ARVO Commercial Relationships Policy: Financial Disclosure in ARVO Presentations and Publications. IOVS 40: 2765-2766 [Full text]