Albumin use in neurosurgical critical care.
OBJECTIVE
To examine the use of albumin in patients receiving neurosurgical intensive care.


METHODS
Survey and chart review of albumin use in neurosurgical intensive care units.


METHODS
University of Kentucky Chandler Medical Center and American Brain Injury Consortium (ABIC).


METHODS
Thirty-eight patients who underwent neurosurgery at the University of Kentucky Chandler Medical Center; members of the ABIC.


METHODS
Chart review with attention to administration of albumin; mailed survey to 200 ABIC members.


RESULTS
Patients admitted to the neurosurgical intensive care unit at the University of Kentucky Chandler Medical Center over a 6-month interval were evaluated. Albumin, either 5% or 25%, was prescribed for approximately 25% of patients. The indications for use were vasospasm and maintenance of cerebral perfusion pressure. The response rate for the ABIC survey was 39%. Respondents stated that normal saline and albumin were both primary fluid choices for the treatment of vasospasm. Twenty-two percent reported a reduction in albumin prescribing following a formal warning statement issued by the Food and Drug Administration regarding the use of albumin in critically ill patients.


CONCLUSIONS
Chart review revealed the primary indications for albumin in the neurosurgical intensive care unit, and our survey data demonstrated the lack of consensus among neurosurgeons regarding their fluid of choice for neurosurgery indications. Prospective, randomized investigations comparing colloids to crystalloids in patients receiving neurosurgical intensive care are required to help define the role of albumin in neurosurgery patients.
Varney
Kimberly L
KL
Department of Pharmacy, University of Kentucky Chandler Medical Center, Lexington, Kentucky 40536-0084, USA.
Young
Byron
B
Hatton
Jimmi
J
D000418:Albumins / Q000008:administration & dosage* / Q000627:therapeutic use; D003422:Critical Care / Q000379:methods* / Q000592:standards; D003625:Data Collection; D004363:Drug Utilization / Q000639:trends; D006801:Humans; D007362:Intensive Care Units; D009493:Neurosurgery; D017410:Practice Guidelines as Topic; D015532:Rehydration Solutions / Q000008:administration & dosage* / Q000627:therapeutic use; D020301:Vasospasm, Intracranial / Q000188:drug therapy
D000418:Albumins; D015532:Rehydration Solutions