Impact of albumin compared to saline on organ function and mortality of patients with severe sepsis

Simon Finfer, Suzanne McEvoy, Rinaldo Bellomo, Colin McArthur, John Myburgh, Robyn Norton

Research output: Contribution to journalArticleResearchpeer-review

224 Citations (Scopus)

Abstract

To determine the effect of random assignment to fluid resuscitation with albumin or saline on organ function and mortality in patients with severe sepsis. Methods: Pre-defined subgroup analysis of a randomized controlled trial conducted in the intensive care units of 16 hospitals in Australia and New Zealand. Results: Of 1,218 patients with severe sepsis at baseline, 603 and 615 were assigned to receive albumin and saline, respectively. The two groups had similar baseline characteristics. During the first 7 days mean arterial pressure was similar in the two groups, but patients assigned albumin had a lower heart rate on days 1 and 3 (p = 0.002 and p = 0.03, respectively) and a higher central venous pressure on days 1-3 (p <0.005 each day). There was no difference in the renal or total Sequential Organ Failure Assessment score of the two groups; 113/603 (18.7 ) of patients assigned albumin were treated with renal replacement therapy compared to 112/615 (18.2 ) assigned saline (p = 0.98). The unadjusted relative risk of death for albumin versus saline was 0.87 [95 confidence interval (CI) 0.74-1.02] for patients with severe sepsis and 1.05 (0.94-1.17) for patients without severe sepsis (p = 0.06 for heterogeneity). From multivariate logistic regression analysis adjusting for baseline factors in patients with complete baseline data (919/1,218, 75.5 ), the adjusted odds ratio for death for albumin versus saline was 0.71 (95 CI: 0.52-0.97; p = 0.03). Conclusions: Administration of albumin compared to saline did not impair renal or other organ function and may have decreased the risk of death.
Original languageEnglish
Pages (from-to)86 - 96
Number of pages11
JournalIntensive Care Medicine
Volume37
Issue number1
DOIs
Publication statusPublished - 2011
Externally publishedYes

Cite this

Finfer, Simon ; McEvoy, Suzanne ; Bellomo, Rinaldo ; McArthur, Colin ; Myburgh, John ; Norton, Robyn. / Impact of albumin compared to saline on organ function and mortality of patients with severe sepsis. In: Intensive Care Medicine. 2011 ; Vol. 37, No. 1. pp. 86 - 96.
@article{e5e54de904214b8987941b0a33448893,
title = "Impact of albumin compared to saline on organ function and mortality of patients with severe sepsis",
abstract = "To determine the effect of random assignment to fluid resuscitation with albumin or saline on organ function and mortality in patients with severe sepsis. Methods: Pre-defined subgroup analysis of a randomized controlled trial conducted in the intensive care units of 16 hospitals in Australia and New Zealand. Results: Of 1,218 patients with severe sepsis at baseline, 603 and 615 were assigned to receive albumin and saline, respectively. The two groups had similar baseline characteristics. During the first 7 days mean arterial pressure was similar in the two groups, but patients assigned albumin had a lower heart rate on days 1 and 3 (p = 0.002 and p = 0.03, respectively) and a higher central venous pressure on days 1-3 (p <0.005 each day). There was no difference in the renal or total Sequential Organ Failure Assessment score of the two groups; 113/603 (18.7 ) of patients assigned albumin were treated with renal replacement therapy compared to 112/615 (18.2 ) assigned saline (p = 0.98). The unadjusted relative risk of death for albumin versus saline was 0.87 [95 confidence interval (CI) 0.74-1.02] for patients with severe sepsis and 1.05 (0.94-1.17) for patients without severe sepsis (p = 0.06 for heterogeneity). From multivariate logistic regression analysis adjusting for baseline factors in patients with complete baseline data (919/1,218, 75.5 ), the adjusted odds ratio for death for albumin versus saline was 0.71 (95 CI: 0.52-0.97; p = 0.03). Conclusions: Administration of albumin compared to saline did not impair renal or other organ function and may have decreased the risk of death.",
author = "Simon Finfer and Suzanne McEvoy and Rinaldo Bellomo and Colin McArthur and John Myburgh and Robyn Norton",
year = "2011",
doi = "10.1007/s00134-010-2039-6",
language = "English",
volume = "37",
pages = "86 -- 96",
journal = "Intensive Care Medicine",
issn = "0342-4642",
publisher = "Springer-Verlag London Ltd.",
number = "1",

}

Impact of albumin compared to saline on organ function and mortality of patients with severe sepsis. / Finfer, Simon; McEvoy, Suzanne; Bellomo, Rinaldo; McArthur, Colin; Myburgh, John; Norton, Robyn.

In: Intensive Care Medicine, Vol. 37, No. 1, 2011, p. 86 - 96.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Impact of albumin compared to saline on organ function and mortality of patients with severe sepsis

AU - Finfer, Simon

AU - McEvoy, Suzanne

AU - Bellomo, Rinaldo

AU - McArthur, Colin

AU - Myburgh, John

AU - Norton, Robyn

PY - 2011

Y1 - 2011

N2 - To determine the effect of random assignment to fluid resuscitation with albumin or saline on organ function and mortality in patients with severe sepsis. Methods: Pre-defined subgroup analysis of a randomized controlled trial conducted in the intensive care units of 16 hospitals in Australia and New Zealand. Results: Of 1,218 patients with severe sepsis at baseline, 603 and 615 were assigned to receive albumin and saline, respectively. The two groups had similar baseline characteristics. During the first 7 days mean arterial pressure was similar in the two groups, but patients assigned albumin had a lower heart rate on days 1 and 3 (p = 0.002 and p = 0.03, respectively) and a higher central venous pressure on days 1-3 (p <0.005 each day). There was no difference in the renal or total Sequential Organ Failure Assessment score of the two groups; 113/603 (18.7 ) of patients assigned albumin were treated with renal replacement therapy compared to 112/615 (18.2 ) assigned saline (p = 0.98). The unadjusted relative risk of death for albumin versus saline was 0.87 [95 confidence interval (CI) 0.74-1.02] for patients with severe sepsis and 1.05 (0.94-1.17) for patients without severe sepsis (p = 0.06 for heterogeneity). From multivariate logistic regression analysis adjusting for baseline factors in patients with complete baseline data (919/1,218, 75.5 ), the adjusted odds ratio for death for albumin versus saline was 0.71 (95 CI: 0.52-0.97; p = 0.03). Conclusions: Administration of albumin compared to saline did not impair renal or other organ function and may have decreased the risk of death.

AB - To determine the effect of random assignment to fluid resuscitation with albumin or saline on organ function and mortality in patients with severe sepsis. Methods: Pre-defined subgroup analysis of a randomized controlled trial conducted in the intensive care units of 16 hospitals in Australia and New Zealand. Results: Of 1,218 patients with severe sepsis at baseline, 603 and 615 were assigned to receive albumin and saline, respectively. The two groups had similar baseline characteristics. During the first 7 days mean arterial pressure was similar in the two groups, but patients assigned albumin had a lower heart rate on days 1 and 3 (p = 0.002 and p = 0.03, respectively) and a higher central venous pressure on days 1-3 (p <0.005 each day). There was no difference in the renal or total Sequential Organ Failure Assessment score of the two groups; 113/603 (18.7 ) of patients assigned albumin were treated with renal replacement therapy compared to 112/615 (18.2 ) assigned saline (p = 0.98). The unadjusted relative risk of death for albumin versus saline was 0.87 [95 confidence interval (CI) 0.74-1.02] for patients with severe sepsis and 1.05 (0.94-1.17) for patients without severe sepsis (p = 0.06 for heterogeneity). From multivariate logistic regression analysis adjusting for baseline factors in patients with complete baseline data (919/1,218, 75.5 ), the adjusted odds ratio for death for albumin versus saline was 0.71 (95 CI: 0.52-0.97; p = 0.03). Conclusions: Administration of albumin compared to saline did not impair renal or other organ function and may have decreased the risk of death.

UR - http://link.springer.com/article/10.1007%2Fs00134-010-2039-6

U2 - 10.1007/s00134-010-2039-6

DO - 10.1007/s00134-010-2039-6

M3 - Article

VL - 37

SP - 86

EP - 96

JO - Intensive Care Medicine

JF - Intensive Care Medicine

SN - 0342-4642

IS - 1

ER -