Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-23T09:01:13.210Z Has data issue: false hasContentIssue false
  • English
  • Français

Albumin administration – what is the evidence of clinical benefit? A systematic review of randomized controlled trials

Published online by Cambridge University Press:  11 July 2005

G. R. Haynes ,
R. J. Navickis  and
M. M. Wilkes
G. R. Haynes
Affiliation:
Medical University of South Carolina, Department of Anesthesia and Perioperative Medicine, Charleston, South Carolina, USA
R. J. Navickis
Affiliation:
Hygeia Associates, Grass Valley, California, USA
M. M. Wilkes
Affiliation:
Hygeia Associates, Grass Valley, California, USA
Get access

Extract

Summary

Background and objective: The advantages of albumin over less costly alternative fluids continue to be debated. Meta-analyses focusing on survival have been inconclusive, and other clinically relevant end-points have not been systematically addressed. We sought to determine whether albumin confers significant clinical benefit in acute illness compared with other fluid regimens.

Methods: Database searches (MEDLINE, EMBASE, Cochrane Library) and other methods were used to identify randomized controlled trials comparing albumin with crystalloid, artificial colloid, no albumin or lower-dose albumin. Major findings for all end-points were extracted and summarized. A quantitative meta-analysis was not attempted.

Results: Seventy-nine randomized trials with a total of 4755 patients were included. No significant treatment effects were detectable in 20/79 (25%) trials. In cardiac surgery, albumin administration resulted in lower fluid requirements, higher colloid oncotic pressure, reduced pulmonary oedema with respiratory impairment and greater haemodilution compared with crystalloid and hydroxyethylstarch increased postoperative bleeding. In non-cardiac surgery, fluid requirements, and pulmonary and intestinal oedema were decreased by albumin compared with crystalloid. In hypoalbuminaemia, higher doses of albumin reduced morbidity. In ascites, albumin reduced haemodynamic derangements, morbidity and length of stay and improved survival after spontaneous bacterial peritonitis. In sepsis, albumin decreased pulmonary oedema and respiratory dysfunction compared with crystalloid, while hydroxyethylstarch induced abnormalities of haemostasis. Complications were lowered by albumin compared with crystalloid in burn patients. Albumin-containing therapeutic regimens improved outcomes after brain injury.

Conclusions: Albumin can bestow benefit in diverse clinical settings. Further trials are warranted to delineate optimal fluid regimens, in particular indications.

Keywords

BRAIN INJURIESCARDIAC SURGICAL PROCEDURESINFECTION, sepsisPATHOLOGICAL PROCESSES, ascitesPROGNOSIS, treatment outcomeRANDOMIZED CONTROLLED TRIALSSERUM ALBUMINSURGERYVITAL STATISTICS, morbidityWOUNDS AND INJURIES, burns
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 10 , November 2003 , pp. 771 - 793
Copyright
© 2003 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Woodruff LM, Gibson ST. The use of human albumin in military medicine. Part II. The clinical evaluation of human albumin. US Navy Med Bull 1942; 40: 791–796.Google Scholar
Janeway CA, Gibson ST, Woodruff LM, et al. Chemical, clinical and immunological studies on the products of human plasma fractionation. VII. Concentrated human serum albumin. J Clin Invest 1944; 23: 465–490.Google Scholar
Boldt J. The good, the bad, and the ugly: should we completely banish human albumin from our intensive care units? Anesth Analg 2000; 91: 887–895.Google Scholar
Human albumin administration in critically ill patients: systematic review of randomised controlled trials. Cochrane Injuries Group Albumin Reviewers. BMJ 1998; 317: 235–240.
Wilkes MM, Navickis RJ. Patient survival after human albumin administration. A meta-analysis of randomized, controlled trials. Ann Intern Med 2001; 135: 149–164.Google Scholar
von Hoegen I, Waller C. Safety of human albumin based on spontaneously reported serious adverse events. Crit Care Med 2001; 29: 994–996.Google Scholar
Fried TR, Bradley EH, Towle VR, Allore H. Understanding the treatment preferences of seriously ill patients. N Engl J Med 2002; 346: 1061–1066.Google Scholar
McMurray L-G, Roe JH, Sweet LK. Plasma protein studies on normal newborn and premature infants. I. Plasma protein values for normal full term and normal premature infants. II. Use of concentrated normal human serum albumin in treatment of premature infants. Am J Dis Child 1948; 75: 265–278.Google Scholar
Recinos PR, Hartford CA, Ziffren SE. Fluid resuscitation of burn patients comparing a crystalloid with a colloid containing solution: a prospective study. J Iowa Med Soc 1975; 65: 426–432.Google Scholar
Lowe RJ, Moss GS, Jilek J, Levine HD. Crystalloid vs colloid in the etiology of pulmonary failure after trauma: a randomized trial in man. Surgery 1977; 81: 676–683.Google Scholar
Moss GS, Lowe RJ, Jilek J, Levine HD. Colloid or crystalloid in the resuscitation of hemorrhagic shock: a controlled clinical trial. Surgery 1981; 89: 434–438.Google Scholar
Shah DM, Browner BD, Dutton RE, Newell JC, Powers Jr SR. Cardiac output and pulmonary wedge pressure. Use for evaluation of fluid replacement in trauma patients. Arch Surg 1977; 112: 1161–1168.Google Scholar
Hallowell P, Bland JH, Dalton BC, et al. The effect of hemodilution with albumin or Ringer's lactate on water balance and blood use in open-heart surgery. Ann Thorac Surg 1978; 25: 22–29.Google Scholar
Boutros AR, Ruess R, Olson L, Hoyt JL, Baker WH. Comparison of hemodynamic, pulmonary, and renal effects of use of three types of fluids after major surgical procedures on the abdominal aorta. Crit Care Med 1979; 7: 9–13.Google Scholar
Jelenko 3rd C, Williams JB, Wheeler ML, et al. Studies in shock and resuscitation. I. Use of a hypertonic, albumin-containing, fluid demand regimen (HALFD) in resuscitation. Crit Care Med 1979; 7: 157–167.Google Scholar
Virgilio RW, Rice CL, Smith DE, et al. Crystalloid vs. colloid resuscitation: is one better? A randomized clinical study. Surgery 1979; 85: 129–139.Google Scholar
Mathru M, Rao TL, Kartha RK, Shanmugham M, Jacobs HK. Intravenous albumin administration for prevention of spinal hypotension during cesarean section. Anesth Analg 1980; 59: 655–658.Google Scholar
Nilsson E, Lamke LO, Liljedahl SO, Elfström K. Is albumin therapy worthwhile in surgery for colorectal cancer? Acta Chir Scand 1980; 146: 619–622.Google Scholar
Zetterström H, Hedstrand U. Albumin treatment following major surgery. I. Effects on plasma oncotic pressure, renal function and peripheral oedema. Acta Anaesthesiol Scand 1981; 25: 125–132.Google Scholar
Zetterström H. Albumin treatment following major surgery. II. Effects on postoperative lung function and circulatory adaptation. Acta Anaesthesiol Scand 1981; 25: 133–141.Google Scholar
Öhqvist G, Settergren G, Bergstrom K, Lundberg S. Plasma colloid osmotic pressure during open-heart surgery using non-colloid or colloid priming solution in the extracorporeal circuit. Scand J Thorac Cardiovasc Surg 1981; 15: 251–255.Google Scholar
Öhqvist G, Settergren G, Lundberg S. Pulmonary oxygenation, central haemodynamics and glomerular filtration following cardiopulmonary bypass with colloid or non-colloid priming solution. Scand J Thorac Cardiovasc Surg 1981; 15: 257–262.Google Scholar
Diehl JT, Lester 3rd JL, Cosgrove DM. Clinical comparison of hetastarch and albumin in postoperative cardiac patients. Ann Thorac Surg 1982; 34: 674–679.Google Scholar
Grundmann R, Meyer H. The significance of colloid osmotic pressure measurement after crystalloid and colloid infusions. Intens Care Med 1982; 8: 179–186.Google Scholar
Goodwin CW, Dorethy J, Lam V, Pruitt Jr BA. Randomized trial of efficacy of crystalloid and colloid resuscitation on hemodynamic response and lung water following thermal injury. Ann Surg 1983; 197: 520–531.Google Scholar
Moggio RA, Rha CC, Somberg ED, Praeger PI, Pooley RW, Reed GE. Hemodynamic comparison of albumin and hydroxyethyl starch in postoperative cardiac surgery patients. Crit Care Med 1983; 11: 943–945.Google Scholar
Rackow EC, Falk JL, Fein IA, et al. Fluid resuscitation in circulatory shock: a comparison of the cardiorespiratory effects of albumin, hetastarch, and saline solutions in patients with hypovolemic and septic shock. Crit Care Med 1983; 11: 839–850.Google Scholar
Saunders CR, Carlisle L, Bick RL. Hydroxyethyl starch versus albumin in cardiopulmonary bypass prime solutions. Ann Thorac Surg 1983; 36: 532–539.Google Scholar
Kirklin JK, Lell WA, Kouchoukos NT. Hydroxyethyl starch versus albumin for colloid infusion following cardiopulmonary bypass in patients undergoing myocardial revascularization. Ann Thorac Surg 1984; 37: 40–46.Google Scholar
Metildi LA, Shackford SR, Virgilio RW, Peters RM. Crystalloid versus colloid in fluid resuscitation of patients with severe pulmonary insufficiency. Surg Gynecol Obstet 1984; 158: 207–212.Google Scholar
Gallagher JD, Moore RA, Kerns D, et al. Effects of colloid or crystalloid administration on pulmonary extravascular water in the postoperative period after coronary artery bypass grafting. Anesth Analg 1985; 64: 753–758.Google Scholar
Grundmann R, Heistermann S. Postoperative albumin infusion therapy based on colloid osmotic pressure. A prospectively randomized trial. Arch Surg 1985; 120: 911–915.Google Scholar
Nielsen OM, Engell HC. Extracellular fluid volume and distribution in relation to changes in plasma colloid osmotic pressure after major surgery. A randomized study. Acta Chir Scand 1985; 151: 221–225.Google Scholar
Sade RM, Stroud MR, Crawford Jr FA, Kratz JM, Dearing JP, Bartles DM. A prospective randomized study of hydroxyethyl starch, albumin, and lactated Ringer's solution as priming fluid for cardiopulmonary bypass. J Thorac Cardiovasc Surg 1985; 89: 713–722.Google Scholar
Boldt J, von Bormann B, Kling D, Borner U, Mulch J, Hempelmann G. Volume replacement with a new hydroxyethyl starch preparation (3 percent HES 200/0.5) in heart surgery. Infusionsther Klin Ernahr 1986; 13: 145–151.Google Scholar
Grundmann R, von Lehndorff C. Indications for postoperative human albumin therapy in the intensive care unit – a prospective randomized study. Langenbecks Arch Chir 1986; 367: 235–246.Google Scholar
Dawidson I, Berglin E, Brynger H, Reisch J. Intravascular volumes and colloid dynamics in relation to fluid management in living related kidney donors and recipients. Crit Care Med 1987; 15: 631–636.Google Scholar
Lumb PD. A comparison between 25% albumin and 6% hydroxyethyl starch solutions on lung water accumulation during and immediately after cardiopulmonary bypass. Ann Surg 1987; 206: 210–213.Google Scholar
Brown RO, Bradley JE, Bekemeyer WB, Luther RW. Effect of albumin supplementation during parenteral nutrition on hospital morbidity. Crit Care Med 1988; 16: 1177–1182.Google Scholar
Falk JL, Rackow EC, Astiz ME, Weil MH. Effects of hetastarch and albumin on coagulation in patients with septic shock. J Clin Pharmacol 1988; 28: 412–415.Google Scholar
Gines P, Tito L, Arroyo V, et al. Randomized comparative study of therapeutic paracentesis with and without intravenous albumin in cirrhosis. Gastroenterology 1988; 94: 1493–1502.Google Scholar
London MJ, Ho JS, Triedman JK, et al. A randomized clinical trial of 10% pentastarch (low molecular weight hydroxyethyl starch) versus 5% albumin for plasma volume expansion after cardiac operations. J Thorac Cardiovasc Surg 1989; 97: 785–797.Google Scholar
Marelli D, Paul A, Samson R, Edgell D, Angood P, Chiu RC. Does the addition of albumin to the prime solution in cardiopulmonary bypass affect clinical outcome? A prospective randomized study. J Thorac Cardiovasc Surg 1989; 98: 751–756.Google Scholar
McGrath LB, Gonzalez-Lavin L, Neary MJ. Comparison of dextran 40 with albumin and Ringer's lactate as components of perfusion prime for cardiopulmonary bypass in patients undergoing myocardial revascularization. Perfusion 1989; 4: 41–49.Google Scholar
Nielsen OM, Thunedborg P, Jorgensen K. Albumin administration and acute phase proteins in abdominal vascular surgery. A randomised study. Dan Med Bull 1989; 36: 496–499.Google Scholar
Rackow EC, Mecher C, Astiz ME, Griffel M, Falk JL, Weil MH. Effects of pentastarch and albumin infusion on cardiorespiratory function and coagulation in patients with severe sepsis and systemic hypoperfusion. Crit Care Med 1989; 17: 394–398.Google Scholar
Bonser RS, Dave JR, Davies ET, et al. Reduction of complement activation during bypass by prime manipulation. Ann Thorac Surg 1990; 49: 279–283.Google Scholar
Foley EF, Borlase BC, Dzik WH, Bistrian BR, Benotti PN. Albumin supplementation in the critically ill. A prospective, randomized trial. Arch Surg 1990; 125: 739–742.Google Scholar
Planas R, Ginés P, Arroyo V, et al. Dextran-70 versus albumin as plasma expanders in cirrhotic patients with tense ascites treated with total paracentesis. Results of a randomized study. Gastroenterology 1990; 99: 1736–1744.Google Scholar
Prien T, Backhaus N, Pelster F, Pircher W, Bunte H, Lawin P. Effect of intraoperative fluid administration and colloid osmotic pressure on the formation of intestinal edema during gastrointestinal surgery. J Clin Anesth 1990; 2: 317–323.Google Scholar
Adam R, Astarcioglu I, Castaing D, Bismuth H. Ringer's lactate vs serum albumin as a flush solution for UW preserved liver grafts: results of a prospective randomized study. Transplant Proc 1991; 23: 2374–2375.Google Scholar
Himpe D, Van Cauwelaert P, Neels H, et al. Priming solutions for cardiopulmonary bypass: comparison of three colloids. J Cardiothorac Vasc Anesth 1991; 5: 457–466.Google Scholar
Hoeft A, Korb H, Mehlhorn U, Stephan H, Sonntag H. Priming of cardiopulmonary bypass with human albumin or Ringer lactate: effect on colloid osmotic pressure and extravascular lung water. Br J Anaesth 1991; 66: 73–80.Google Scholar
Salerno F, Badalamenti S, Lorenzano E, Moser P, Incerti P. Randomized comparative study of hemaccel vs. albumin infusion after total paracentesis in cirrhotic patients with refractory ascites. Hepatology 1991; 13: 707–713.Google Scholar
Boldt J, Zickmann B, Ballesteros BM, Stertmann F, Hempelmann G. Influence of five different priming solutions on platelet function in patients undergoing cardiac surgery. Anesth Analg 1992; 74: 219–225.Google Scholar
Fassio E, Terg R, Landeira G, et al. Paracentesis with Dextran 70 vs. paracentesis with albumin in cirrhosis with tense ascites. Results of a randomized study. J Hepatol 1992; 14: 310–316.Google Scholar
Goslinga H, Eijzenbach V, Heuvelmans JH, et al. Custom-tailored hemodilution with albumin and crystalloids in acute ischemic stroke. Stroke 1992; 23: 181–188.Google Scholar
Kanarek KS, Williams PR, Blair C. Concurrent administration of albumin with total parenteral nutrition in sick newborn infants. J Parenter Enteral Nutr 1992; 16: 49–53.Google Scholar
London MJ, Franks M, Verrier ED, Merrick SH, Levin J, Mangano DT. The safety and efficacy of ten percent pentastarch as a cardiopulmonary bypass priming solution. A randomized clinical trial. J Thorac Cardiovasc Surg 1992; 104: 284–296.Google Scholar
Wojtysiak SL, Brown RO, Roberson D, Powers DA, Kudsk KA. Effect of hypoalbuminemia and parenteral nutrition on free water excretion and electrolyte-free water resorption. Crit Care Med 1992; 20: 164–169.Google Scholar
Boldt J, Knothe C, Zickmann B, Andres P, Dapper F, Hempelmann G. Influence of different intravascular volume therapies on platelet function in patients undergoing cardiopulmonary bypass. Anesth Analg 1993; 76: 1185–1190.Google Scholar
Boldt J, Knothe C, Schindler E, Hammermann H, Dapper F, Hempelmann G. Volume replacement with hydroxyethyl starch solution in children. Br J Anaesth 1993; 70: 661–665.Google Scholar
Garcia-Compeán D, Zacarias Villarreal J, Bahena Cuevas H, et al. Total therapeutic paracentesis (TTP) with and without intravenous albumin in the treatment of cirrhotic tense ascites: a randomized controlled trial. Liver 1993; 13: 233–238.Google Scholar
Greenough A, Emery E, Hird MF, Gamsu HR. Randomised controlled trial of albumin infusion in ill preterm infants. Eur J Pediatr 1993; 152: 157–159.Google Scholar
Videm V, Fosse E, Svennevig JL. Platelet preservation during coronary bypass surgery with bubble and membrane oxygenators: effect of albumin priming. Perfusion 1993; 8: 409–415.Google Scholar
Woods MS, Kelley H. Oncotic pressure, albumin and ileus: the effect of albumin replacement on postoperative ileus. Am Surg 1993; 59: 758–763.Google Scholar
Golub R, Sorrento Jr JJ, Cantu Jr R, Nierman DM, Moideen A, Stein HD. Efficacy of albumin supplementation in the surgical intensive care unit: a prospective, randomized study. Crit Care Med 1994; 22: 613–619.Google Scholar
Mastroianni L, Low HB, Rollman J, Wagle M, Bleske B, Chow MS. A comparison of 10% pentastarch and 5% albumin in patients undergoing open-heart surgery. J Clin Pharmacol 1994; 34: 34–40.Google Scholar
Tomita H, Ito U, Tone O, Masaoka H, Tominaga B. High colloid oncotic therapy for contusional brain edema. Acta Neurochir Suppl (Wien) 1994; 60: 547–549.Google Scholar
Greenhalgh DG, Housinger TA, Kagan RJ, et al. Maintenance of serum albumin levels in pediatric burn patients: a prospective, randomized trial. J Trauma 1995; 39: 67–73; discussion 73–74.Google Scholar
Jenkins IR, Curtis AP. The combination of mannitol and albumin in the priming solution reduces positive intraoperative fluid balance during cardiopulmonary bypass. Perfusion 1995; 10: 301–305.Google Scholar
Luca A, Garcia-Pagán JC, Bosch J, et al. Beneficial effects of intravenous albumin infusion on the hemodynamic and humoral changes after total paracentesis. Hepatology 1995; 22: 753–758.Google Scholar
Tølløfsrud S, Svennevig JL, Breivik H, et al. Fluid balance and pulmonary functions during and after coronary artery bypass surgery: Ringer's acetate compared with dextran, polygeline, or albumin. Acta Anaesthesiol Scand 1995; 39: 671–677.Google Scholar
Brutocao D, Bratton SL, Thomas JR, Schrader PF, Coles PG, Lynn AM. Comparison of hetastarch with albumin for postoperative volume expansion in children after cardiopulmonary bypass. J Cardiothorac Vasc Anesth 1996; 10: 348–351.Google Scholar
Gines A, Fernandez-Esparrach G, Monescillo A, et al. Randomized trial comparing albumin, dextran 70, and polygeline in cirrhotic patients with ascites treated by paracentesis. Gastroenterology 1996; 111: 1002–1010.Google Scholar
Wahba A, Sendtner E, Birnbaum DE. Fluid resuscitation with Haemaccel vs. human albumin following coronary artery bypass grafting. Thorac Cardiovasc Surg 1996; 44: 178–182.Google Scholar
Buhre W, Hoeft A, Schorn B, Weyland A, Scholz M, Sonntag H. Acute affect of mitral calve replacement on extravascular lung water in patients receiving colloid or crystalloid priming of cardiopulmonary bypass. Br J Anaesth 1997; 79: 311–316.Google Scholar
Hondebrink Y, Jeekel L, Nijhuis JO, Woittiez AJ. Restoration of colloid osmotic pressure in hypoalbuminaemic patients. Intensive Care Med 1997; 23: S138.Google Scholar
Woittiez AJ, van Baal JG. Increased risk of death in critically ill patients after treatment with human albumin? Ned Tijdschr Geneeskd 1998; 142: 2161–2162.Google Scholar
Rubin H, Carlson S, DeMeo M, Ganger D, Craig RM. Randomized, double-blind study of intravenous human albumin in hypoalbuminemic patients receiving total parenteral nutrition. Crit Care Med 1997; 25: 249–252.Google Scholar
Saxena N, Chauhan S, Ramesh GS. A comparison of hetastarch, albumin and Ringer lactate for volume replacement in coronary artery bypass surgery. J Anaesth Clin Pharmacol 1997; 13: 117–120.Google Scholar
Tigchelaar I, Gallandat Huet RC, Korsten J, Boonstra PW, van Oeveren W. Hemostatic effects of three colloid plasma substitutes for priming solution in cardiopulmonary bypass. Eur J Cardiothorac Surg 1997; 11: 626–632.Google Scholar
Tigchelaar I, Gallandat Huet RC, Boonstra PW, van Oeveren W. Comparison of three plasma expanders used as priming fluids in cardiopulmonary bypass patients. Perfusion 1998; 13: 297–303.Google Scholar
Altman C, Bernard B, Roulot D, Vitte RL, Ink O. Randomized comparative multicenter study of hydroxyethyl starch versus albumin as a plasma expander in cirrhotic patients with tense ascites treated with paracentesis. Eur J Gastroenterol Hepatol 1998; 10: 5–10.Google Scholar
Gentilini P, Casini-Raggi V, Di Fiore G, et al. Albumin improves the response to diuretics in patients with cirrhosis and ascites: results of a randomized, controlled trial. J Hepatol 1999; 30: 639–645.Google Scholar
Sort P, Navasa M, Arroyo V, et al. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis. N Engl J Med 1999; 341: 403–409.Google Scholar
Lennihan L, Mayer SA, Fink ME, et al. Effect of hypervolemic therapy on cerebral blood flow after subarachnoid hemorrhage: a randomized controlled trial. Stroke 2000; 31: 383–391.Google Scholar
Gurkan F, Haspolat K, Yaramis A, Ece A. Beneficial effect of human albumin on neonatal cerebral edema. Am J Ther 2001; 8: 253–254.Google Scholar
Petroni KC, Green R, Birmingham S. Hextend® is a safe alternative to 5% human albumin for patients undergoing elective cardiac surgery. Anesthesiology 2001; 95: A198.Google Scholar
Lucas CE, Weaver D, Higgins RF, Ledgerwood AM, Johnson SD, Bouwman DL. Effects of albumin versus non-albumin resuscitation on plasma volume and renal excretory function. J Trauma 1978; 18: 564–570.Google Scholar
Smith CA, Phillips KG, Roth RO. Effects and fate of human serum albumin administered intravenously and orally to premature infants. J Clin Invest 1950; 29: 218–226.Google Scholar
Vincent J-L, Dubois M-J, Navickis RJ, Wilkes MM. Hypoalbuminemia in acute illness – is there a rationale for intervention? A meta-analysis of cohort studies and controlled trials. Ann Surg 2003; 237: 319–334.Google Scholar
Rackow EC, Fein IA, Leppo J. Colloid osmotic pressure as a prognostic indicator of pulmonary edema and mortality in the critically ill. Chest 1977; 72: 709–713.Google Scholar
Rackow EC, Fein IA, Siegel J. The relationship of the colloid osmotic-pulmonary artery wedge pressure gradient to pulmonary edema and mortality in critically ill patients. Chest 1982; 82: 433–437.Google Scholar
Belisle S, Hardy JF. Hemorrhage and the use of blood products after adult cardiac operations: myths and realities. Ann Thorac Surg 1996; 62: 1908–1917.Google Scholar
Unsworth-White MJ, Herriot A, Valencia O, et al. Resternotomy for bleeding after cardiac operation: a marker for increased morbidity and mortality. Ann Thorac Surg 1995; 59: 664–667.Google Scholar
Moulton MJ, Creswell LL, Mackey ME, Cox JL, Rosenbloom M. Reexploration for bleeding is a risk factor for adverse outcomes after cardiac operations. J Thorac Cardiovasc Surg 1996; 111: 1037–1046.Google Scholar
Gravlee GP, Arora S, Lavender SW, et al. Predictive value of blood clotting tests in cardiac surgical patients. Ann Thorac Surg 1994; 58: 216–221.Google Scholar
Wilkes MM, Navickis RJ, Sibbald WJ. Albumin versus hydroxyethyl starch in cardiopulmonary bypass surgery: a meta-analysis of postoperative bleeding. Ann Thorac Surg 2001; 72: 527–533; discussion 534.Google Scholar
Herwaldt LA, Swartzendruber SK, Edmond MB, et al. The epidemiology of hemorrhage related to cardiothoracic operations. Infect Control Hosp Epidemiol 1998; 19: 9–16.Google Scholar
Vincent JL. Fluid management: the pharmacoeconomic dimension. Crit Care 2000; 4 (Suppl 2): S33–S35.Google Scholar
Gibbs J, Cull W, Henderson W, Daley J, Hur K, Khuri SF. Preoperative serum albumin level as a predictor of operative mortality and morbidity: results from the National VA Surgical Risk Study. Arch Surg 1999; 134: 36–42.Google Scholar
Practice parameters for hemodynamic support of sepsis in adult patients in sepsis. Task Force of the American College of Critical Care Medicine, Society of Critical Care Medicine. Crit Care Med 1999; 27: 639–660.
Toole JG. Use of hetastarch for volume expansion. J Neurosurg 1987; 66: 636–637.Google Scholar
Trumble ER, Muizelaar JP, Myseros JS, Choi SC, Warren BB. Coagulopathy with the use of hetastarch in the treatment of vasospasm. J Neurosurg 1995; 82: 44–47.Google Scholar
Hypervolemic hemodilution treatment of acute stroke. Results of a randomized multicenter trial using pentastarch. The Hemodilution in Stroke Study Group. Stroke 1989; 20: 317–323.
Mast H, Marx P. Neurological deterioration under isovolemic hemodilution with hydroxyethyl starch in acute cerebral ischemia. Stroke 1991; 22: 680–683.Google Scholar
de Jonge E, Levi M. Effects of different plasma substitutes on blood coagulation: a comparative review. Crit Care Med 2001; 29: 1261–1267.Google Scholar
Zoellner H, Hou JY, Lovery M, et al. Inhibition of microvascular endothelial apoptosis in tissue explants by serum albumin. Microvasc Res 1999; 57: 162–173.Google Scholar
Rhee P, Wang D, Ruff P, et al. Human neutrophil activation and increased adhesion by various resuscitation fluids. Crit Care Med 2000; 28: 74–78.Google Scholar
Kamada T, McMillan DE, Sternlieb JJ, Bjork VO, Otsuji S. Albumin prevents erythrocyte crenation in patients undergoing extracorporeal circulation. Scand J Thorac Cardiovasc Surg 1988; 22: 155–158.Google Scholar
Fliser D, Zurbruggen I, Mutschler E, et al. Coadministration of albumin and furosemide in patients with the nephrotic syndrome. Kidney Int 1999; 55: 629–634.Google Scholar
Lindow J, Wijdicks EF. Phenytoin toxicity associated with hypoalbuminemia in critically ill patients. Chest 1994; 105: 602–604.Google Scholar
Bergman I, Steeves M, Burckart G, Thompson A. Reversible neurologic abnormalities associated with prolonged intravenous midazolam and fentanyl administration. J Pediatr 1991; 119: 644–649.Google Scholar