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Albumin: saint or sinner?
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Introduction |
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The choice of colloid or crystalloid solutions in adult and
paediatric resuscitation has been the subject of ongoing debate for
many years. A systematic review recently published in the BMJ
has again brought this debate to the fore, by indicating that patients treated with human albumin solution (HAS) may have an increased mortality.1 The review examined the use of HAS
for its licensed indications: hypoalbuminaemia; hypovolaemia from trauma or surgery; and burns. On closer analysis, it is evident that
the main aim of many of the studies included was to compare haemodynamic variables and the effects of HAS on nutritive status, rather than to assess the effects of HAS on mortality. While two of the
included studies evaluated HAS use in preterm infants, only one
assessed HAS in sepsis and none evaluated treatment of critically ill
children with HAS. The authors of the systematic review concluded that
the use of
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