Efficacy of albumin supplementation in the surgical intensive care unit: a prospective, randomized study.
OBJECTIVE
To determine the efficacy of supplemental 25% albumin in reducing morbidity and mortality rates in the surgical intensive care unit (ICU).


METHODS
Prospective, randomized, unblinded clinical study.


METHODS
Surgical ICU in a community hospital.


METHODS
Two hundred nineteen patients with admission circulating albumin concentrations of < 3.0 g/dL (< 30 g/L). The groups were well matched regarding age, sex, Acute Physiology and Chronic Health Evaluation II scores and initial circulating albumin concentrations.


METHODS
The treatment group (n = 116) received 37.5 g/day of albumin until the circulating albumin concentration increased to > 3.0 g/dL (> 30 g/L). The control group (n = 103) received no supplemental albumin. Both groups received standard nutritional support.


RESULTS
The complication rate was 44% in the albumin group vs. 36.9% in the controls (p = .29). The albumin patients had a mortality rate of 10.3% vs. 5.8% in the control group (p = .22). There were no significant differences between the groups in the number of days spent receiving mechanical ventilation or in the tolerance to tube feedings.


CONCLUSIONS
Routine supplemental administration of 25% albumin is expensive and offers no apparent outcome advantage and should be abandoned in the treatment of patients in the surgical ICU.
Golub
R
R
Department of Surgery, Flushing Hospital Medical Center, NY 11355.
Sorrento
J J
JJ
Cantu
R
R
Nierman
D M
DM
Moideen
A
A
Stein
H D
HD
D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000009:adverse effects*; D003422:Critical Care / Q000379:methods*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012709:Serum Albumin; D012720:Severity of Illness Index
D000418:Albumins; D012709:Serum Albumin