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Five percent albumin for adult burn shock resuscitation: lack of effect on daily multiple organ dysfunction score
Author(s) -
Cooper Andrew B.,
Cohn Stephen M.,
Zhang Haibo S.,
Hanna Kim,
Stewart Thomas E.,
Slutsky Arthur S.
Publication year - 2006
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2005.00667.x
Subject(s) - resuscitation , medicine , shock (circulatory) , organ dysfunction , albumin , intensive care medicine , anesthesia , sepsis
BACKGROUND: The effect of 5 percent human albumin on multiple organ dysfunction was investigated during the first 14 days of treatment to determine whether albumin resuscitation might benefit adult burn patients. STUDY DESIGN AND METHODS: Multicenter unblinded controlled trial with stratified block (two patients per block) randomization by center and mortality prediction at enrollment (high‐risk stratum [predicted mortality, 50%‐90%] and low‐risk stratum [predicted mortality, <50%]). The primary outcome was the worst multiple organ dysfunction score (MODS), excluding the cardiovascular component, to Day 14. Eligible adults (>15 years) suffering from thermal injury not more than 12 hours before enrollment received fluid resuscitation with Ringer's lactate (n = 23) or 5 percent human albumin plus Ringer's lactate (n = 19) by protocol to achieve recommended (American Burn Association) resuscitation endpoints. RESULTS: Forty‐two patients were randomly assigned. There were no significant differences (median [95% confidence intervals]) in age (36 [24‐45] vs. 31 [25‐39] years), burn size (39 [32‐53] vs. 32 [26‐34] total body surface area percentage), inhalation injury (n = 12/19 vs. n = 11/23), or baseline MODS (3 [1‐5] vs. 1.5 [0‐2]) between the treatment and control groups. In an intention‐to‐treat analysis, there was no significant difference between the treatment and control group in the lowest MODS from Day 0 to Day 14 (analysis of covariance, p = 0.73). CONCLUSION: Treatment with 5 percent albumin from Day 0 to Day 14 does not decrease the burden of MODS in adult burn patients.