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Intervention: Patients were randomly assigned to receive either 4% albumin or normal saline, with randomization stratified according to institution and whether there was a diagnosis of trauma on admission to the ICU. Study fluids were supplied in identical 500-ml bottles, and blinding was ensured through the use of specially designed masking cartons and specially designed and manufactured administration sets. The effectiveness of the blinding was confirmed in a formal study before the trial was initiated. The treating clinicians determined the amount and rate of fluid administration. In addition to the study fluid, patients received maintenance fluids, specific replacement fluids, enteral or parenteral nutrition, and blood products at the discretion of the treating clinicians. The monitoring of central venous pressure, pulmonary-artery catheterization, and all other aspects of patient care were performed at the discretion of the treating clinicians.

Comparison of Albumin and Saline for Fluid Resuscitation in the Intensive Care Unit