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LETTERS: Ian Roberts, Philip Edwards, Brian McLelland, Brendan J Fogarty, and Khalid Khan More on albumin BMJ 1999; 318: 1214b [Full text]

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Albumin again

James C Watts   (18 July 1999)

Albumin again 18 July 1999
James C Watts, Consultant in Anaesthesia and Intensive Care Burnley General Hospital Send response to journal: Re: Albumin again	Editor, without wishing to re ignite the albumin debate which has raged across the pages of the journal, it seems legitimate to raise an issue with regards to the recent communication and news report on this subject (1)(2).The original article (3) has been condemned by several authorities including a reviewer , Neil Soni, who declared in the pages of this journal that it "should not be published" (4). Furthermore, an analysis in the Intensive Care Society Newsletter (5) dismissed its conclusions as, despite drawing together data from many studies, the number of patients involved was inadequate to demonstrate the differences in mortality claimed. This conclusion appears to be supported by the recent statement from the Committee of Safety of Medicines which stated that "the indication for human albumin solutions should focus on the use of albumin to replace lost fluids" and that there is "insufficient evidence of harm to warrent withdrawal of albumin products ". They reccommend the conduct of purpose designed trials to answer the question (6) which surely should have been the conclusion of the original article from the Cochrane group. Unfortunately, these are unlikely to ever occur, since the chairman of the Cochrane Institute sensibly encouraged people to sue if they had recieved albumin when critically ill and survived.(7) references 1. Roberts I Edwards P McLelland B more on albumin BMJ 1999 318. 1214 -5 2. Woodman R Doctor's advised to take special care with human albumin BMJ 1999 318 1643 3. Cochrane injuries group Albumin Reviewers Human albumin administration in critically ill patients: systematic review of randomised controlled trials BMJ 317 1998 235-40 4.Soni N Untitled BMJ 1998 317 882 5.Webb A Journal reviews 1998 intensive Care Society Newsletter (Autumn) 6. Committee of Safety of Medicines The safety of human albumin Current problems in pharmacovigilance 1999 25.11 7. Chalmers I I would not want an albumin transfusion BMJ 317 1998 885