ALBIOS TRIAL PDF

Corresponding author. Received May 24; Accepted Aug This article has been cited by other articles in PMC. Abstract Background A reanalysis of the ALBIOS trial suggested that patients with septic shock - defined by vasopressor-dependent hypotension in the presence of severe sepsis Shock-2 - had a survival benefit when treated with albumin. We investigated how the populations defined according to Shock-2 and Shock-3 differed and whether the albumin benefit would be confirmed.

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Human albumin boosts oncotic pressure, and has a number of important biologic functions protein binding, antioxidant, etc. Among patients with sepsis, there was a nonsignificant trend toward improved survival among those receiving albumin. A small trial of critically ill patients suggested giving albumin to those with low levels could improve organ function, but a meta-analysis of 30 trials suggested albumin could harm the critically ill.

With million units of normal saline infused each year in the U. Both groups got crystalloid as needed for fluid replacement. The albumin did seem to have physiologic benefits, producing lower heart rates and higher mean arterial pressure. Patients receiving albumin did have improved organ function scores for heart, coagulation, and liver. Most interestingly: although the overall trial was negative, the mortality findings split according to disease severity.

The study did not test albumin as a resuscitation fluid; albumin was given to improve hypoalbuminemia. Patients had already undergone goal directed therapy before receiving albumin, and crystalloids were given to both groups as fluid replacement.

Also, because it was an open label and treatment teams knew the randomization assignments, unmeasured difference in care delivered could have affected the results. The lack of benefit in the SAFE study and the severe sepsis arm of the current trial, along with a Cochrane analysis suggesting harm , argue for restraint in using this expensive resource. However, albumin advocates will find confirmation of their practices in the hemodynamic benefits seen here, and especially the increased survival among the sickest patients with septic shock.

Pietro Caironi et al. N Engl J Med ;

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Volume Replacement With Albumin in Severe Sepsis (ALBIOS)

Human albumin boosts oncotic pressure, and has a number of important biologic functions protein binding, antioxidant, etc. Among patients with sepsis, there was a nonsignificant trend toward improved survival among those receiving albumin. A small trial of critically ill patients suggested giving albumin to those with low levels could improve organ function, but a meta-analysis of 30 trials suggested albumin could harm the critically ill. With million units of normal saline infused each year in the U. Both groups got crystalloid as needed for fluid replacement. The albumin did seem to have physiologic benefits, producing lower heart rates and higher mean arterial pressure. Patients receiving albumin did have improved organ function scores for heart, coagulation, and liver.

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ALBumin Italian Outcome Septic Shock-BALANCED Trial (ALBIOSS-BALANCED) (ALBIOSS-BAL)

Abstract Background A reanalysis of the ALBIOS trial suggested that patients with septic shock - defined by vasopressor-dependent hypotension in the presence of severe sepsis Shock-2 - had a survival benefit when treated with albumin. We investigated how the populations defined according to Shock-2 and Shock-3 differed and whether the albumin benefit would be confirmed. We compared group size, physiological variables and day mortality between patients defined by Shock-2 and Shock-3 and between the albumin and crystalloid treatment groups. Results We compared the Shock-2 and the Shock-3 definitions and the albumin and crystalloid treatment groups in terms of group size and physiological, laboratory and outcome variables. Albumin decreased mortality in Shock-2 patients compared to crystalloids

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Septic shock-3 vs 2: an analysis of the ALBIOS study

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