Editorial

Efficacy of albumin in critically ill patients

BMJ 2003; 326 doi: 10.1136/bmj.326.7389.559 (Published 15 March 2003)
Cite this as: BMJ 2003;326:559

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Large trial in Australia and New Zealand may provide an answer

  1. Simon Finfer, chair (ctg@anzics.com.au),
  2. Rinaldo Bellomo, member (ctg@anzics.com.au),
  3. John Myburgh, deputy chair (ctg@anzics.com.au),
  4. Robyn Norton, co-director
  1. ANZICS Clinical Trials Group, ANZICS House, 233 Rathdowne Street, Carlton, Victoria 3053, Australia
  2. Institute for International Health, University of Sydney, Newtown, NSW 2042, Australia

    In 1998, the BMJ published a meta-analysis that compared the effects of fluids containing albumin and crystalloids on death rates in critically ill patients.1 The analysis included 24 studies involving 1419 patients. The report concluded that there was no evidence that albumin reduced mortality and a strong implication that it might increase the risk of death. The authors recommended that use of albumin in critically ill patients be reviewed urgently and that albumin should not be used outside the context of rigorously conducted randomised controlled trials. Despite the fact that the reviewers themselves advised that their results must be interpreted with caution, an accompanying editorial called for a total halt to the use of albumin in critically ill patients.2 In the following weeks, numerous editorials and letters published in the BMJ debated the various merits of using albumin, without reaching consensus.3–6

    As we approach the …

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