Albumin replacement in patients with severe sepsis or septic shock.

6533b85cfe1ef96bd12bd47a

RESEARCH PRODUCT

Albumin replacement in patients with severe sepsis or septic shock.

Gattinoni L Caironi P Pesenti A Fumagalli R Tognoni G Romero M Latini R Masson S Vincent Jl Suter Pm Valsecchi Mg Santosuosso A Cavana M Ortu A Gabini R Perno S Anelli A Amoruso R Ferraris S Borelli M Massei R Poli G Riva I Papagni G Bortone F Mamprin F Keim R Brivio M Colageo U Mimii Ep Sangiorgi G Siniscalchi A Pierucci E Giovannitti A Gentile C Pascucci F Antonini B Zummo U Valsecchi R Cerisara M Trezzi T Dossena A Ribola A Tamayo L Zoppellari R Volta Ca Mangani V Fanfani E Chelazzi C Bartoli T Parrini V Oggioni R Fedele A Molin A Berri C Guarino A Isetta M Bonfiglio M Tissino F Silvestri L Milanesi M Sbrana G Motta E Iannaco I Casadio Mc Pasetti Gs Palandini A Cascione C Puscio D Cellai F Boccalatte D Silvestri S Fausto Ci Lupo V Zompanti V Iacobone E Gattari D Ronzoni G Beck E Francesconi S Colombo R Raimondi F Castelli A De Gasperi A Radrizzani D Ferla Le Giudici R Bellato V Bordone G Gavazzeni V Lesmo A Ripamonti D Vesconi S Papoff A Rossi A Noto A Pezzi A Zanforlin G Kandil H Ballotta A Bettini F Vaghi Gm Rossi S Pessina C Casagrande D Trivellato A Costagli V Moise G Furla M Marelli S Caspani L Panigada M Bruzzone P Isgrò S Abbruzzese C Tagliabue P Solca M Bonazzi M Cattaneo A Rossi N Andreoni P Pasetto A Girardis M Barbieri E Piazza O Zagara G Bono M Galzerano A Garzilli T Dentini N Bindi M Biancofiore G Mercante Wp Disconzi Mm Todesco N Lunardi S Sani E Carli M Bracciotti G Gori V Braccini P Maggio G Braschi A Bottazzi A Iotti G Nicora B Salati G Salsi P Antonelli M Pennisi Ma Bello G Caccese R D'ambrosio M Rocco M Sanseverino M Gatta A Nastasi M Corsi A Facondini F Franchi F Mongelli P Ferrario M Carulli F Del Curto S Schiappacasse G Dalpiaz C Armani S Verderosa I Marzullo A Tonetti F De Piero Me Livigni S Fiore G Cerutti A Erbetta S Napolitano R Pastorelli M Bona F Debernardi F Gallo M Segala V Parigi L Perzolla D Marson F Chiarandini P Cammarano C Sermann G De Lucia S Frigerio A Distaso F Franco R Bossi E Laudi C De Nardin M Violo T Lazzari F Vestali A Della Mora E Polati E Martini A Cristallini S Totaro C Milan B Dan M Ruberti S Danzi V.Antonino Giarratano Santi Maurizio Raineri Andrea Cortegiani

subject

Male medicine.medical_specialty ALBUMIN SEPSIS SEVERE SEPSIS SEPTIC SHOCK Sepsi Serum albumin Settore MED/41 - Anestesiologia Aged; Albumins; Female; Humans; Isotonic Solutions; Male; Middle Aged; Rehydration Solutions; Sepsis; Serum Albumin; Shock Septic; Survival Rate; Treatment Outcome Sepsis Intensive care Albumins Sepsis medicine Humans albumin replacement Survival rate Serum Albumin Isotonic Solution Aged Aged; Albumins; Female; Humans; Isotonic Solutions; Male; Middle Aged; Rehydration Solutions; Sepsis; Serum Albumin; Shock Septic; Survival Rate; Treatment Outcome; Medicine (all)SEPSIS biology business.industry Septic shock Rehydration Solution Septic Medicine (all)Albumin SEPTIC SHOCK Organ dysfunction Albumin Shock General Medicine Middle Aged medicine.disease Shock Septic Surgery Survival Rate Treatment Outcome Anesthesia Relative risk Rehydration Solutions biology.protein Female medicine.symptom Isotonic Solutions business Human

description

BACKGROUND: Although previous studies have suggested the potential advantages of albumin administration in patients with severe sepsis, its efficacy has not been fully established. METHODS: In this multicenter, open-label trial, we randomly assigned 1818 patients with severe sepsis, in 100 intensive care units (ICUs), to receive either 20% albumin and crystalloid solution or crystalloid solution alone. In the albumin group, the target serum albumin concentration was 30 g per liter or more until discharge from the ICU or 28 days after randomization. The primary outcome was death from any cause at 28 days. Secondary outcomes were death from any cause at 90 days, the number of patients with organ dysfunction and the degree of dysfunction, and length of stay in the ICU and the hospital. RESULTS: During the first 7 days, patients in the albumin group, as compared with those in the crystalloid group, had a higher mean arterial pressure (P = 0.03) and lower net fluid balance (P<0.001). The total daily amount of administered fluid did not differ significantly between the two groups (P = 0.10). At 28 days, 285 of 895 patients (31.8%) in the albumin group and 288 of 900 (32.0%) in the crystalloid group had died (relative risk in the albumin group, 1.00; 95% confidence interval [CI], 0.87 to 1.14; P = 0.94). At 90 days, 365 of 888 patients (41.1%) in the albumin group and 389 of 893 (43.6%) in the crystalloid group had died (relative risk, 0.94; 95% CI, 0.85 to 1.05; P = 0.29). No significant differences in other secondary outcomes were observed between the two groups. CONCLUSIONS: In patients with severe sepsis, albumin replacement in addition to crystalloids, as compared with crystalloids alone, did not improve the rate of survival at 28 and 90 days. (Funded by the Italian Medicines Agency; ALBIOS ClinicalTrials.gov number, NCT00707122.) Copyright © 2014 Massachusetts Medical Society. All rights reserved.

year	journal	country	edition	language
2014-04-10

10.1056/nejmoa1305727 http://hdl.handle.net/11573/612987