SynthesisCritical care (London, England)2014
Comparison of the effects of albumin and crystalloid on mortality in adult patients with severe sepsis and septic shock: a meta-analysis of randomized clinical trials.
Synthesis in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 6 syntheses or guidelines pooled it, 143 citations in OpenAlex.
- Albumin for people with liver cirrhosis and bacterial infections.The Cochrane database of systematic reviews · 2026Pooled it
- Mortality effect of albumin fluid resuscitation in adults with septic shock: a systematic review and dual frequentist-bayesian meta-analysis of randomised trials.Critical care (London, England) · 2026Pooled it
- The effect of human albumin administration on postoperative renal function following major surgery: a systematic review and meta-analysis.Scientific reports · 2024Pooled it
- Pooled it
- Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016.Intensive care medicine · 2017Guideline
- Comparison of the effects of albumin and crystalloid on mortality among patients with septic shock: systematic review with meta-analysis and trial sequential analysis.Sao Paulo medical journal = Revista paulista de medicinaPooled it
- Comparison of 5% human albumin and normal saline for fluid resuscitation in sepsis induced hypotension among patients with cirrhosis (FRISC study): a randomized controlled trial.Hepatology international · 2021Trial
- [Focus on Albumin: new perspectives for the clinical application in intensive care medicine : From the quantitative routine to qualitative individualized theranostics].Die Anaesthesiologie · 2026Review
- Review
- Assessing the clinical impact of albumin infusion in critically ill ICU patients with acute myocardial infarction and hypoalbuminemia: a retrospective propensity score-matched cohort study.BMC cardiovascular disorders · 2026Article
- Use of Human Serum Albumin in Critically Ill Patients: A Narrative Review.Journal of clinical medicine · 2026Review
- The Physiology, Pathophysiology, and Clinical Implications of Fluid Resuscitation in Critically Ill Patients.Cureus · 2026Review
- Management of endothelial dysfunction in septic shock: role of albumin administration.Journal of intensive care · 2025Article
- Age-stratified mortality and associated risk factors in adults aged 65 years or older undergoing continuous kidney replacement therapy: a consecutive retrospective study.BMC nephrology · 2025Article
- Insight into the Roles of Albumin-Alone and in Combination with Either Voriconazole or Antimicrobial Peptides Derived from Chromogranin A-In the Growth of Different Microbial Species.Antibiotics (Basel, Switzerland) · 2025Article
- The influence of fluid resuscitation strategy on outcomes from dengue shock syndrome: a review of the management of 691 children in 7 Southeast Asian hospitals.BMJ global health · 2025Article
- Step-by-step causal analysis of EHRs to ground decision-making.PLOS digital health · 2025Article
- Impact of Early Albumin Use for Resuscitation in Patients With Septic Shock and Cirrhosis.Canadian journal of gastroenterology & hepatology · 2025Article
- Association between albumin infusion and sepsis risk of patients with acute pancreatitis.PloS one · 2025Article
- [Volume therapy: which preparation for which situation?]Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe aim of this study was to examine whether albumin reduced mortality when employed for the resuscitation of adult patients with severe sepsis and septic shock compared with crystalloid by meta-analysis.
methodsWe searched for and gathered data from MEDLINE, Elsevier, Cochrane Central Register of Controlled Trials and Web of Science databases. Studies were eligible if they compared the effects of albumin versus crystalloid therapy on mortality in adult patients with severe sepsis and septic shock. Two reviewers extracted data independently. Disagreements were resolved by discussion with other two reviewers until a consensus was achieved. Data including mortality, sample size of the patients with severe sepsis, sample size of the patients with septic shock and resuscitation endpoints were extracted. Data were analyzed by the methods recommended by the Cochrane Collaboration Review Manager 4.2 software.
resultsA total of 5,534 records were identified through the initial search. Five studies compared albumin with crystalloid. In total, 3,658 severe sepsis and 2,180 septic shock patients were included in the meta-analysis. The heterogeneity was determined to be non-significant (P = 0.86, I(2) = 0%). Compared with crystalloid, a trend toward reduced 90-day mortality was observed in severe sepsis patients resuscitated with albumin (odds ratio (OR) 0.88; 95% CI, 0.76 to 1.01; P = 0.08). However, the use of albumin for resuscitation significantly decreased 90-day mortality in septic shock patients (OR 0.81; 95% CI, 0.67 to 0.97; P = 0.03). Compared with saline, the use of albumin for resuscitation slightly improved outcome in severe sepsis patients (OR 0.81; 95% CI, 0.64 to 1.08; P = 0.09).
conclusionsIn this meta-analysis, a trend toward reduced 90-day mortality was observed in severe sepsis patients resuscitated with albumin compared with crystalloid and saline. Moreover, the 90-day mortality of patients with septic shock decreased significantly.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.