A comparison of albumin and saline for fluid resuscitation in the intensive care unit. Export

@article{citeulike:507349, abstract = {BACKGROUND: It remains uncertain whether the choice of resuscitation fluid for patients in intensive care units (ICUs) affects survival. We conducted a multicenter, randomized, double-blind trial to compare the effect of fluid resuscitation with albumin or saline on mortality in a heterogeneous population of patients in the ICU. METHODS: We randomly assigned patients who had been admitted to the ICU to receive either 4 percent albumin or normal saline for intravascular-fluid resuscitation during the next 28 days. The primary outcome measure was death from any cause during the 28-day period after randomization. RESULTS: Of the 6997 patients who underwent randomization, 3497 were assigned to receive albumin and 3500 to receive saline; the two groups had similar baseline characteristics. There were 726 deaths in the albumin group, as compared with 729 deaths in the saline group (relative risk of death, 0.99; 95 percent confidence interval, 0.91 to 1.09; P=0.87). The proportion of patients with new single-organ and multiple-organ failure was similar in the two groups (P=0.85). There were no significant differences between the groups in the mean (+/-SD) numbers of days spent in the ICU (6.5+/-6.6 in the albumin group and 6.2+/-6.2 in the saline group, P=0.44), days spent in the hospital (15.3+/-9.6 and 15.6+/-9.6, respectively; P=0.30), days of mechanical ventilation (4.5+/-6.1 and 4.3+/-5.7, respectively; P=0.74), or days of renal-replacement therapy (0.5+/-2.3 and 0.4+/-2.0, respectively; P=0.41). CONCLUSIONS: In patients in the ICU, use of either 4 percent albumin or normal saline for fluid resuscitation results in similar outcomes at 28 days.}, address = {ANZICS CTG, Level 3, 10 Ievers St., Carlton, VIC 3053, Australia. ctg@anzics.com.au}, author = {Finfer, S. and Bellomo, R. and Boyce, N. and French, J. and Myburgh, J. and Norton, R. and {}}, citeulike-article-id = {507349}, citeulike-linkout-0 = {http://dx.doi.org/10.1056/NEJMoa040232}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/15163774}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=15163774}, day = {27}, doi = {10.1056/NEJMoa040232}, issn = {1533-4406}, journal = {N Engl J Med}, keywords = {22, albumin, fluids, safe, saline}, month = {May}, number = {22}, pages = {2247--2256}, posted-at = {2008-05-26 12:27:57}, priority = {2}, title = {A comparison of albumin and saline for fluid resuscitation in the intensive care unit.}, url = {http://dx.doi.org/10.1056/NEJMoa040232}, volume = {350}, year = {2004} }

TY - JOUR ID - citeulike:507349 L3 - citeulike-article-id:507349 N2 - BACKGROUND: It remains uncertain whether the choice of resuscitation fluid for patients in intensive care units (ICUs) affects survival. We conducted a multicenter, randomized, double-blind trial to compare the effect of fluid resuscitation with albumin or saline on mortality in a heterogeneous population of patients in the ICU. METHODS: We randomly assigned patients who had been admitted to the ICU to receive either 4 percent albumin or normal saline for intravascular-fluid resuscitation during the next 28 days. The primary outcome measure was death from any cause during the 28-day period after randomization. RESULTS: Of the 6997 patients who underwent randomization, 3497 were assigned to receive albumin and 3500 to receive saline; the two groups had similar baseline characteristics. There were 726 deaths in the albumin group, as compared with 729 deaths in the saline group (relative risk of death, 0.99; 95 percent confidence interval, 0.91 to 1.09; P=0.87). The proportion of patients with new single-organ and multiple-organ failure was similar in the two groups (P=0.85). There were no significant differences between the groups in the mean (+/-SD) numbers of days spent in the ICU (6.5+/-6.6 in the albumin group and 6.2+/-6.2 in the saline group, P=0.44), days spent in the hospital (15.3+/-9.6 and 15.6+/-9.6, respectively; P=0.30), days of mechanical ventilation (4.5+/-6.1 and 4.3+/-5.7, respectively; P=0.74), or days of renal-replacement therapy (0.5+/-2.3 and 0.4+/-2.0, respectively; P=0.41). CONCLUSIONS: In patients in the ICU, use of either 4 percent albumin or normal saline for fluid resuscitation results in similar outcomes at 28 days. IS - 22 JF - N Engl J Med SN - 1533-4406 AD - ANZICS CTG, Level 3, 10 Ievers St., Carlton, VIC 3053, Australia. ctg@anzics.com.au EP - 2256 TI - A comparison of albumin and saline for fluid resuscitation in the intensive care unit. VL - 350 SP - 2247 KW - 22 KW - albumin KW - fluids KW - safe KW - saline AU - Finfer, S AU - Bellomo, R AU - Boyce, N AU - French, J AU - Myburgh, J AU - Norton, R PY - 2004/05/27/ UR - http://dx.doi.org/10.1056/NEJMoa040232 ER -