title: A comparison of albumin and saline for fluid resuscitation in the intensive care unit.
abstract: BACKGROUND
  It remains uncertain whether the choice of resuscitation fluid for patients in intensive care units (ICUs) affects survival. We conducted a multicenter, randomized, double-blind trial to compare the effect of fluid resuscitation with albumin or saline on mortality in a heterogeneous population of patients in the ICU.
  
  
  METHODS
  We randomly assigned patients who had been admitted to the ICU to receive either 4 percent albumin or normal saline for intravascular-fluid resuscitation during the next 28 days. The primary outcome measure was death from any cause during the 28-day period after randomization.
  
  
  RESULTS
  Of the 6997 patients who underwent randomization, 3497 were assigned to receive albumin and 3500 to receive saline; the two groups had similar baseline characteristics. There were 726 deaths in the albumin group, as compared with 729 deaths in the saline group (relative risk of death, 0.99; 95 percent confidence interval, 0.91 to 1.09; P=0.87). The proportion of patients with new single-organ and multiple-organ failure was similar in the two groups (P=0.85). There were no significant differences between the groups in the mean (+/-SD) numbers of days spent in the ICU (6.5+/-6.6 in the albumin group and 6.2+/-6.2 in the saline group, P=0.44), days spent in the hospital (15.3+/-9.6 and 15.6+/-9.6, respectively; P=0.30), days of mechanical ventilation (4.5+/-6.1 and 4.3+/-5.7, respectively; P=0.74), or days of renal-replacement therapy (0.5+/-2.3 and 0.4+/-2.0, respectively; P=0.41).
  
  
  CONCLUSIONS
  In patients in the ICU, use of either 4 percent albumin or normal saline for fluid resuscitation results in similar outcomes at 28 days.
authors.affiliation: ANZICS CTG, Level 3, 10 Ievers St., Carlton, VIC 3053, Australia. ctg@anzics.com.au
authors.forename: Simon
authors.initials: S
authors.lastname: Finfer
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
authors.forename: Neil
authors.initials: N
authors.lastname: Boyce
authors.forename: Julie
authors.initials: J
authors.lastname: French
authors.forename: John
authors.initials: J
authors.lastname: Myburgh
authors.forename: Robyn
authors.initials: R
authors.lastname: Norton
mesh_terms: D000328:Adult; D000418:Albumins / Q000627:therapeutic use*; D001794:Blood Pressure; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D004311:Double-Blind Method; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006339:Heart Rate; D006801:Humans; D020896:Hypovolemia / Q000503:physiopathology / Q000628:therapy*; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000453:epidemiology; D012306:Risk; D012965:Sodium Chloride / Q000627:therapeutic use*; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000418:Albumins; D012965:Sodium Chloride