Albumin infusion in spontaneous bacterial peritonitis: another brick off the wall?

Excerpt

Albumin infusion did not convey any survival benefit compared to normal saline in a randomized controlled study (RCT) which involved a very large population of ICU patients who required intravascular fluid resuscitation [1]. There was, however, a nonsignificant trend in favor of albumin in patients with severe sepsis [2]. This trend was contradicted in another RCT which did not show any difference in mortality when albumin was added to normal saline during severe sepsis or septic shock compared with saline alone [3]. Post hoc analyses, with their inherent limitation, suggested a trend for higher mortality in patients with severe sepsis without shock who received albumin and a significant reduction in mortality with albumin in patients with septic shock [3]. A conservative conclusion of all these studies is the lack of strong evidence in favor of albumin during sepsis without shock. …