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

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