Evidence map›Paper›PMID 26981172›Full record

ReviewWorld journal of hepatology2016

Human albumin solution for patients with cirrhosis and acute on chronic liver failure: Beyond simple volume expansion.

Christopher Valerio, Eleni Theocharidou, Andrew Davenport, Banwari Agarwal

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in World journal of hepatology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Article
  3. Article
  4. Update on the Complications and Management of Liver Cirrhosis.Medical sciences (Basel, Switzerland) · 2025
    Review
  5. Article
  6. Role of albumin infusion in cirrhosis-associated complications.Clinical and experimental medicine · 2024
    Review
  7. Review
  8. Review
  9. Article
  10. Article
  11. Review
  12. QCM-based assay designs for human serum albumin.Analytical and bioanalytical chemistry · 2022
    Article
  13. Article
  14. Article
  15. Article
  16. Pharmacological Interactions in the Elderly.Medicina (Kaunas, Lithuania) · 2020
    Review
  17. Review
  18. Review
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Christopher ValerioChristopher Valerio, Banwari Agarwal, Intensive Care Unit, Royal Free Hospital, Royal Free Hampstead NHS Trust, University College London, London NW3 2QG, United Kingdom.
Eleni TheocharidouChristopher Valerio, Banwari Agarwal, Intensive Care Unit, Royal Free Hospital, Royal Free Hampstead NHS Trust, University College London, London NW3 2QG, United Kingdom.
Andrew DavenportChristopher Valerio, Banwari Agarwal, Intensive Care Unit, Royal Free Hospital, Royal Free Hampstead NHS Trust, University College London, London NW3 2QG, United Kingdom.
Banwari AgarwalChristopher Valerio, Banwari Agarwal, Intensive Care Unit, Royal Free Hospital, Royal Free Hampstead NHS Trust, University College London, London NW3 2QG, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

To provide an overview of the properties of human serum albumin (HSA), and to review the evidence for the use of human albumin solution (HAS) in critical illness, sepsis and cirrhosis. A MEDLINE search was performed using the terms "human albumin", "critical illness", "sepsis" and "cirrhosis". The references of retrieved articles were reviewed manually. Studies published between 1980 and 2014 were selected based on quality criteria. Data extraction was performed by all authors. HSA is the main plasma protein contributing greatly to its oncotic pressure. HSA demonstrates important binding properties for endogenous and exogenous toxins, drugs and drug metabolites that account for its anti-oxidant and anti-inflammatory properties. In disease states, hypoalbuminaemia is secondary to decreased HSA production, increased loss or transcapillary leakage into the interstitial space. HSA function can be also altered in disease with reduced albumin binding capacity and increased production of modified isoforms. HAS has been used as volume expander in critical illness, but received criticism due to cost and concerns regarding safety. More recent studies confirmed the safety of HAS, but failed to show any survival benefit compared to the cheaper crystalloid fluids, therefore limiting its use. On the contrary, in cirrhosis there is robust data to support the efficacy of HAS for the prevention of circulatory dysfunction post-large volume paracentesis and in the context of spontaneous bacterial peritonitis, and for the treatment of hepato-renal syndrome and hypervolaemic hyponatraemia. It is likely that not only the oncotic properties of HAS are beneficial in cirrhosis, but also its functional properties, as HAS replaces the dysfunctional HSA. The role of HAS as the resuscitation fluid of choice in critically ill patients with cirrhosis, beyond the established indications for HAS use, should be addressed in future studies.

Indexed as

CirrhosisCritical illnessHepatorenal syndromeHuman albumin solutionHuman serum albuminLarge-volume paracentesisResuscitation fluidSpontaneous bacterial peritonitis

Identifiers

PMID26981172
PMCPMC4779163

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.