Albumin Administration in Patients With Sepsis
Authors: Bram Rochwerg, Waleed Alhazzani, Roman Jaeschke, Deborah J. Cook
Journal: Annals of Internal Medicine (2015)

Letters17 February 2015Albumin Administration in Patients With SepsisBram Rochwerg, MD, Waleed Alhazzani, MD, Roman Jaeschke, MD, and Deborah J. Cook, MDBram Rochwerg, MDFrom McMaster University Medical Centre, Hamilton, Ontario, Canada; and St. Joseph's Healthcare, Hamilton, Ontario, Canada., Waleed Alhazzani, MDFrom McMaster University Medical Centre, Hamilton, Ontario, Canada; and St. Joseph's Healthcare, Hamilton, Ontario, Canada., Roman Jaeschke, MDFrom McMaster University Medical Centre, Hamilton, Ontario, Canada; and St. Joseph's Healthcare, Hamilton, Ontario, Canada., and Deborah J. Cook, MDFrom McMaster University Medical Centre, Hamilton, Ontario, Canada; and St. Joseph's Healthcare, Hamilton, Ontario, Canada.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5051-2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Zhang and colleagues for their points about the administration of albumin for resuscitation in patients with sepsis. The methods of their meta-analysis differ from those of ours in several respects, and it is thus unsurprising that our results are discordant. We used an NMA framework that has the advantage of incorporating indirect evidence as opposed to only direct evidence as in a conventional meta-analysis.We excluded the ALBIOS (1) and EARSS (2) studies because albumin administration in these trials was independent of hemodynamic instability and the focus of our NMA was resuscitation fluid. We included ...References1. Caironi P, Tognoni G, Masson S, Fumagalli R, Pesenti A, Romero M, et al; ALBIOS Study Investigators. Albumin replacement in patients with severe sepsis or septic shock. N Engl J Med. 2014;370:1412-21. [PMID: 24635772] doi:10.1056/NEJMoa1305727 CrossrefMedlineGoogle Scholar2. Charpentier J, Mira J-P. Efficacy and tolerance of hyperoncotic albumin administration in septic shock patients: the EARSS study. Intensive Care Med. 2011;37 Suppl 1 S115. Google Scholar3. Annane D, Siami S, Jaber S, Martin C, Elatrous S, Declère AD, et al; CRISTAL Investigators. Effects of fluid resuscitation with colloids vs crystalloids on mortality in critically ill patients presenting with hypovolemic shock: the CRISTAL randomized trial. JAMA. 2013;310:1809-17. [PMID: 24108515] doi:10.1001/jama.2013.280502 CrossrefMedlineGoogle Scholar4. Finfer S, Bellomo R, Boyce N, French J, Myburgh J, Norton R; SAFE Study Investigators. A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med. 2004;350:2247-56. [PMID: 15163774] CrossrefMedlineGoogle Scholar5. Rochwerg B, Wludarczyk A, Szczeklik W, Alhazzani W, Sindi A, Alshamsi F, et al; FISSH group. Fluid resuscitation in severe sepsis and septic shock: systematic description of fluids used in randomized trials. Pol Arch Med Wewn. 2013;123:603-8. [PMID: 24185099] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From McMaster University Medical Centre, Hamilton, Ontario, Canada; and St. Joseph's Healthcare, Hamilton, Ontario, Canada.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-0178. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoFluid Resuscitation in Sepsis Bram Rochwerg , Waleed Alhazzani , Anees Sindi , Diane Heels-Ansdell , Lehana Thabane , Alison Fox-Robichaud , Lawrence Mbuagbaw , Wojciech Szczeklik , Fayez Alshamsi , Sultan Altayyar , Wang-Chun Ip , Guowei Li , Michael Wang , Anna Włudarczyk , Qi Zhou , Gordon H. Guyatt , Deborah J. Cook , Roman Jaeschke , Djillali Annane , and Fluid Resuscitation in Sepsis Bram Rochwerg , Waleed Alhazzani , Anees Sindi , Diane Heels-Ansdell , Lehana Thabane , Alison Fox-Robichaud , Lawrence Mbuagbaw , Wojciech Szczeklik , Fayez Alshamsi , Sultan Altayyar , Wang-Chun Ip , Guowei Li , Michael Wang , Anna Włudarczyk , Qi Zhou , Gordon H. Guyatt , Deborah J. Cook , Roman Jaeschke , Djillali Annane , and Albumin Administration in Patients With Sepsis Libing Jiang , Yuefeng Ma , and Mao Zhang Albumin Administration in Patients With Sepsis Libing Jiang , Yuefeng Ma , and Mao Zhang Metrics 17 February 2015Volume 162, Issue 4Page: 319-320KeywordsAlbuminsAttentionChloridesDisclosureHemodynamicsResuscitationSepsis ePublished: 17 February 2015 Issue Published: 17 February 2015 CopyrightCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...