Human albumin and starch administration in critically ill patients: a prospective randomized clinical trial.

  • TF V
  • J O
  • AJ W
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Abstract

OBJECTIVE: To determine whether intravenous infusion of either human albumin or hydroxyethyl-starch (HES) in hypo-albuminemic critically ill may lead to an increase in colloid osmotic pressure and to a better clinical outcome, i.e. lower mortality and fewer complications, compared to fluid replacement with normal saline. DESIGN: Prospective, randomized controlled clinical trial during 72 hours in 61 consecutively admitted severely ill patients. Randomisation took place by sealed envelope, kept outside of the hospital. SETTING: Intensive care unit of the Twenteborg Hospital, Almelo, The Netherlands. SUBJECTS: Sixty-three severely ill, hypo-albuminemic patients were selected; 27 patients had severe sepsis and 36 were post-surgical patients with SIRS. Two patients died shortly after randomization, 15 patients received human albumin, 15 HES 500 and 15 HES 1000 ml, and 16 saline. INTERVENTIONS: The patients were randomized to receive 300 ml human albumin (20%) per day, or 1000 ml normal saline per day, or 500 ml or 1000 ml HES per day, all for 72 hours. MAIN OUTCOME MEASURES: The primary outcome was plasma colloid osmotic pressure (COP). Secondary endpoints were fluid balance and the development of pulmonary edema. RESULTS: Administration of human albumin was effective in raising COP (P

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Authors

  • Veneman TF

  • Oude Nijhuis J

  • Woittiez AJ

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