Table 2 Randomized clinical trials of hyperoncotic albumin in sepsis
Trial | n | Indication | Regimen | Results |
|---|---|---|---|---|
Boldt et al., 1995 [44] | 30 | Sepsis after major surgery | 20% albumin vs 10% HES 200/0.5 to 12–16 mm Hg target CVP, PCWP or both | Plasma thrombomodulin increased in albumin group and remained unchanged in HES 200/0.5 group (p < 0.05); plasma protein C among HES 200/0.5 recipients increased on days 4 and 5 without corresponding change in albumin group (p < 0.05) |
Boldt et al., 1996 [45] | 30 | Sepsis secondary to major general surgery | 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, RVEF, PaO2/FiO2, DO2I and VO2I and decreased SVRI (p < 0.05 for all comparisons); pHi decreased in albumin but not HES 200/0.5 group (p < 0.05) |
Boldt et al., 1996 [46] | 28 | Sepsis after major surgery | 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 [47] | 42 | Sepsis secondary to major surgery | 20% albumin vs 6% HES 200/0.5 vs pentoxyfylline (300 mg bolus plus 1.4 mg/kg/h continuous infusion) | Circulating sELAM-1 and sICAM-1 concentrations reduced by HES 200/0.5 compared with albumin (p < 0.05 for both comparisons) |
Boldt et al., 1996 [48] | 28 | Sepsis secondary to major surgery | 20% albumin vs 10% HES 200/0.5 to 10–15 mm Hg target PCWP | Vasopressin, endothelin-1, norepinephrine and 6-keto-prostaglandin F1a decreased and pHi increased in HES 200/0.5 but not albumin group (p < 0.05 for all comparisons); ANP increased by albumin but not HES 200/0.5 (p < 0.05) |
Boldt et al., 1998 [49] | 150 | Postoperative sepsis | 20% albumin vs 10% HES 200/0.5 to 12–15 mm Hg target PCWP | PaO2/FiO2 increased and lactate decreased by HES 200/0.5 but not albumin (p < 0.05 for both comparisons); 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 |
Palumbo et al., 2006 [59] | 20 | Severe sepsis | 20% albumin vs 6% HES 130/0.4 | PCWP of 15–18 mm Hg successfully maintained by both colloids throughout the 5-day study period; temperature, MAP, pulmonary artery pressure, CVP, heart rate and urine output remained stable in both groups; HES increased cardiac index and several oxygenation parameters and decreased APACHE II score |