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Báo cáo y học: "Albumin in critical care: SAFE, but worth its salt"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Albumin in critical care: SAFE, but worth its salt? | Available online http ccforum.eom content 8 5 297 Commentary Albumin in critical care SAFE but worth its salt Eddy Fan1 and Thomas E Stewart2 1Medical Resident Department of Medicine University of Toronto Ontario Canada 2Director Critical Care Units Mount Sinai Hospital and University Health Network Toronto Ontario Canada and Associate Professor Department of Anesthesia and Department of Medicine University of Toronto Ontario Canada Corresponding author Thomas E Stewart tom.stewart@utoronto.ca Published online 20 August 2004 Critical Care 2004 8 297-299 DOI 10.1186 cc2943 This article is online at http ccforum.com content 8 5 297 2004 BioMed Central Ltd Abstract Intravascular fluid therapy is a common critical care intervention. However the optimal type of resuscitation fluid crystalloid or colloid remains controversial. Despite the many theoretical benefits of human albumin administration in critically ill patients there has been little evidence to support its widespread clinical use. Previous systematic reviews have led to conflicting results regarding the safety and efficacy of albumin. The recently reported Saline versus Albumin Evaluation study has provided conclusive evidence that 4 albumin is as safe as saline for resuscitation although no overall benefit of albumin use was seen. Subgroup analysis of the albumin-treated group revealed a trend towards decreased mortality in patients with septic shock and a trend towards increased mortality in trauma patients especially those with traumatic brain injury. The results of these subgroups as well as the use of higher albumin concentrations and other synthetic colloids dextrans starches require rigorous evaluation in clinical trials. Finally the Saline versus Albumin Evaluation trial represents a methodological milestone in critical care medicine due to its size its efficient trial design and its logistical coordination. Future studies are still required however to establish a therapeutic niche for albumin and .