Albumin administration for fluid resuscitation in burn patients: A systematic review and meta-analysis.
OBJECTIVE
The objective was to systematically review the literature summarizing the effect on mortality of albumin compared to non-albumin solutions during the fluid resuscitation phase of burn injured patients.


METHODS
We searched MEDLINE, EMBASE and CENTRAL and the content of two leading journals in burn care, Burns and Journal of Burn Care and Research.


METHODS
Two reviewers independently selected randomized controlled trials comparing albumin vs. non-albumin solutions for the acute resuscitation of patients with >20% body surface area involvement.


METHODS
Reviewers abstracted data independently and assessed methodological quality of the included trials using predefined criteria.


RESULTS
A random effects model was used to assess mortality. We identified 164 trials of which, 4 trials involving 140 patients met our inclusion criteria. Overall, the methodological quality of the included trials was fair. We did not find a significant benefit of albumin solutions as resuscitation fluid on mortality in burn patients (relative risk (RR) 1.6; 95% confidence interval (CI), 0.63-4.08). Total volume of fluid infusion during the phase of resuscitation was lower in patients receiving albumin containing solution -1.00ml/kg/%TBSA (total body surface area) (95% CI, -1.42 to -0.58).


CONCLUSIONS
The pooled estimate demonstrated a neutral effect on mortality in burn patients resuscitated acutely with albumin solutions. Due to limited evidence and uncertainty, an adequately powered, high quality trial could be required to assess the impact of albumin solutions on mortality in burn patients.
Department of Critical Care Medicine, Université de Montréal, Canada. Electronic address: roberto.eljaiek@umontreal.ca.
Roberto
R
Eljaiek
Department of Anesthesiology, Hôpital Sacre-Coeur de Montréal, Canada.
Christophe
C
Heylbroeck
Department of Critical Care Medicine, Université de Montréal, Canada; Critical Care Division and Montreal Burn Center, Hôtel-Dieu de Montréal, Canada.
Marc-Jacques
MJ
Dubois
D000418:Albumins / Q000627:therapeutic use*; D002056:Burns / Q000401:mortality / Q000628:therapy*; D003102:Colloids; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D012151:Resuscitation; D016896:Treatment Outcome
D000418:Albumins; D003102:Colloids
Albumin; Burn; Fluid resuscitation; Meta-analysis; Systematic review