Albumin As a Resuscitative Fluid in Patients with Severe Sepsis: A Randomized Clinical Trial

Abstract

Fluid therapy is an essential part of resuscitation of the patients with severe sepsis and  different methods has been suggested for. One of these methods is to add colloids  like  albumin to the crystalloid fluids, yet there are serious controversies about its effectiveness. To determine the effect of adding albumin to crystalloid fluids on the outcome of the severe sepsis, we performed this study. 20 patients (12 men and 8 women, with the mean age of 58) with severe sepsis who needed resuscitation, who were hospitalized in Imam Reza medical education center. The study began on march 2015 and ended on march 2016. The patients were randomized into two groups. One group received crystalloid fluids and routine management procedures and the other group received albumin (two vials of 20% albumin)  alongside those two mentioned. Mortality  was the primary endpoint. Secondary endpoints were the length of hospitalization, the need for mechanical ventilation, dialysis and organ failure. 28 and 90 day mortality in the albumin group was 10 and 40 percent, respectively (p value=0. 58), and they were 30 and 50 percent in the control group, respectively (p value=0. 5). None of the patients needed dialysis and there were no significant differences between the two groups from the organ failure point of view. The median length of hospitalization in both ICU and general ward was significantly higher in the albumin group  (16 days VS 7.5 days, p value= 0.03 and 32 days VS  12 days, p value=0.02). PaO2 and O2Sat were lower but not significant in the albumin group. Adding albumin to the crystalloid fluids in order to resuscitate the patients with severe sepsis, only results in prolongation of the hospitalization length in both ICU and general ward and has no notable clinical benefit.Trial registration  www.IRCT.org/ IRCT 2016040316473N5