Skip to main content

Table 1 Randomized clinical trials of hyperoncotic albumin in surgery and trauma

From: Small-volume resuscitation with hyperoncotic albumin: a systematic review of randomized clinical trials

Trial n Indication Regimen Results
Cardiac surgery     
Boldt et al., 1986 [37] 55 Coronary artery bypass grafting 300 ml 20% albumin intraoperatively after bypass vs 500 ml 3% HES 200/0.5 vs 500 ml 3.5% gelatin vs no additional volume Post-bypass COP rebound greater in albumin than other groups (p < 0.05)
Boldt et al., 1993 [41] 30 Cardiac defect repair in children < 3 years old 20% albumin vs 6% HES 200/0.5 to stabilize hemodynamics before bypass On-bypass urine output in HES group lower by 57% than that of albumin group (p < 0.05)
Magder and Lagonidis, 1999 [52] 28 Stable patients after cardiac bypass surgery 100 ml 25% albumin vs saline to increase right atrial pressure by 2 mm Hg Greater increase in cardiac output among hyperoncotic albumin recipients, suggesting an inotropic effect
Non-cardiac surgery     
Zetterström and Hedstrand, 1981 [36] 30 Elective major abdominal surgery 300–400 ml 20% albumin on operation day, 200 ml on next day and 100 ml/day for subsequent 3 days vs no albumin In albumin recipients COP significantly closer to preoperative level on postoperative days 2–6
Prien et al., 1990 [39] 18 Abdominal surgery 20% albumin vs 10% HES 200/0.5 vs Ringer's lactate to maintain preoperative CVP Significantly lower intraoperative intestinal edema after albumin compared with either HES or Ringer's lactate; impaired coagulation in HES recipients
Trauma     
Boldt et al., 1995 [44] 30 Trauma of ISS > 15 20% albumin vs 10% HES 200/0.5 to 12–16 mm Hg target CVP, PCWP or both No between-group differences in daily profiles of plasma thrombomodulin, proteins C and S and thrombin-antithrombin III
Boldt et al., 1996 [45] 30 Trauma of ISS between 15 and 30 20% albumin vs 10% HES 200/0.5 to 12–18 mm Hg target PCWP HES 200/0.5 but not albumin increased cardiac index, PaO2/FiO2, DO2I and VO2I (p < 0.05 for all comparisons)
Boldt et al., 1996 [46] 28 Trauma of ISS > 15 20% albumin vs 10% HES 200/0.5 to 12–16 mm Hg target CVP, PCWP or both Maximum platelet aggregation declined in both groups (p < 0.05)
Boldt et al., 1996 [48] 28 Trauma of ISS > 15 20% albumin vs 10% HES 200/0.5 to 10–15 mm Hg target PCWP Vasopressin decreased in HES 200/0.5 but not albumin group (p < 0.05)
Boldt et al., 1998 [49] 150 Trauma of ISS > 15 20% albumin vs 10% HES 200/0.5 to 12–15 mm Hg target PCWP PaO2/FiO2 increased by HES 200/0.5 but not albumin (p < 0.05); higher cardiac index, DO2I and VO2I in HES 200/0.5 group (p < 0.05 for all comparisons); no differences in incidence of renal failure, platelet count, PT or aPTT
  1. aPTT, activated partial thromboplastin time; COP, colloid oncotic pressure; CVP, central venous pressure; DO2I, oxygen delivery index; HES, hydroxyethyl starch; ISS, injury severity score; PaO2/FiO2, ratio of partial pressure of arterial oxygen to fraction of inspired oxygen; PCWP, pulmonary capillary wedge pressure; PT, prothrombin time; VO2I, oxygen consumption index.