title: Human albumin administration in subarachnoid hemorrhage: results of an international survey.
abstract: BACKGROUND
  Subarachnoid hemorrhage (SAH) is a devastating disease. Nimodipine is the only medical treatment shown to improve outcome of SAH patients. Human albumin (ALB) may exert neuroprotection in SAH. However, current usage of ALB in SAH is not known. We conducted an international survey of clinicians involved in the care of SAH patients to determine current practice of ALB administration in SAH.
  
  
  METHODS
  We constructed a 27-question survey. Our sampling frame consisted of neurointensivists, general intensivists, neurocritical care nurses, critical care pharmacists, and neurosurgeons. The survey was available from 11/15/2012 to 12/15/2012. We performed mostly descriptive statistical analysis.
  
  
  RESULTS
  We obtained 362 responses from a diverse range of world regions. Most respondents were intensivist physicians (88 %), who worked in academic institutions (73.5 %) with a bed capacity >500 (64.1 %) and an established institutional management protocol for SAH patients (70.2 %). Most respondents (83.5 %) indicated that their institutions do not incorporate ALB in their protocol, but half of them (45.9 %) indicated using ALB outside it. ALB administration is influenced by several factors: geographic variation (more common among US respondents); institutions with a dedicated neuroICU; and availability of SAH management protocol. Most respondents (75 %) indicated that a clinical trial to test the efficacy of ALB in SAH is needed.
  
  
  CONCLUSIONS
  In this survey we found that ALB administration in SAH patients is common and influenced by several factors. Majority of respondents support a randomized clinical trial to determine the safety and efficacy of ALB administration in SAH patients.
authors.affiliation: Division of Vascular Neurology and Neurocritical Care, Department of Neurology, Baylor College of Medicine, 1 Baylor Plaza, NB:320, Houston, TX, 77030, USA, jisuarez@bcm.tmc.edu.
authors.forename: Jose I
authors.initials: JI
authors.lastname: Suarez
authors.forename: Renee H
authors.initials: RH
authors.lastname: Martin
authors.forename: Eusebia
authors.initials: E
authors.lastname: Calvillo
authors.forename: David
authors.initials: D
authors.lastname: Zygun
authors.forename: Oliver
authors.initials: O
authors.lastname: Flower
authors.forename: George K
authors.initials: GK
authors.lastname: Wong
authors.forename: Eric M
authors.initials: EM
authors.lastname: Bershad
authors.forename: Chethan P
authors.initials: CP
authors.lastname: Venkatasubba Rao
authors.forename: Alexandros
authors.initials: A
authors.lastname: Georgiadis
authors.forename: Draga
authors.initials: D
authors.lastname: Jichici
authors.forename: Peter D
authors.initials: PD
authors.lastname: Leroux
mesh_terms: D000328:Adult; D002985:Clinical Protocols; D003422:Critical Care / Q000379:methods; D019538:Health Care Surveys; D006801:Humans; D009462:Neurology / Q000379:methods; D018696:Neuroprotective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012709:Serum Albumin / Q000008:administration & dosage / Q000627:therapeutic use*; D000075462:Serum Albumin, Human; D013345:Subarachnoid Hemorrhage / Q000188:drug therapy*
chemical_list: C422455:ALB protein, human; D018696:Neuroprotective Agents; D012709:Serum Albumin; D000075462:Serum Albumin, Human