Trial reportJAMA network open2026
Albumin Replacement Therapy in Septic Shock: A Randomized Clinical Trial.
Trial report in JAMA network open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT03869385 (Randomised Controlled Multicentre Study of Albumin Replacement Therapy in Septic Shock), which is not on this map. Cited by 13 papers, 3 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.
Randomised Controlled Multicentre Study of Albumin Replacement Therapy in Septic Shock
Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Hyperoncotic Albumin (20%) Versus Crystalloids for Mortality in Adults with Sepsis and Septic Shock: An Updated Systematic Review and Meta-Analysis.Medical sciences (Basel, Switzerland) · 2026Pooled it
- Targeting capillary leak in experimental sepsis and endotoxemia: a systematic review of therapeutic agents, methods and models in animal studies.Critical care (London, England) · 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
- Prognostic significance of the blood urea nitrogen-to-serum albumin ratio in patients with septic shock.Experimental and therapeutic medicine · 2026Article
- The Unknown Benefits of Dermal Matrices in Prevent Loss of Albumin in Patient with Major Burns.European burn journal · 2026Article
- [Focus on Albumin: new perspectives for the clinical application in intensive care medicine : From the quantitative routine to qualitative individualized theranostics].Die Anaesthesiologie · 2026Review
- The Acid-Base Effects of Albumin in Sepsis: Reconciling the Stewart Physicochemical Approach with the Traditional Buffer-Base Paradigm.Journal of clinical medicine · 2026Review
- Review
- Error in Methods.JAMA network open · 2026Article
- Albumin 20% in surgical and critically ill patients; a comprehensive review.Critical care (London, England) · 2026Review
- Determinants of effectiveness in orthopedic ERAS: a cross-setting perspective based on the integration of nutritional status and clinical outcomes.Frontiers in nutrition · 2026Article
- Septic shock in the era of precision medicine: rethinking fluids, vasopressors, and immunomodulation.Frontiers in medicine · 2026Review
- Oxygen delivery, hemodilution and transfusion in critical illness: an underrecognized safety signal in albumin randomized trials.Blood transfusion = Trasfusione del sangueArticle
Corrections and comments
- Erratum issued
Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Albumin supplementation may reduce mortality in patients with septic shock; however, data from randomized clinical trials are limited. Objective: To assess the impact of albumin administration on outcomes in patients with septic shock. Design, Setting, and Participants: This multicenter, open-label randomized clinical trial was conducted between October 21, 2019, and May 2, 2022. Patients from 23 intensive care units in Germany enrolled within 24 hours of the onset of septic shock were followed up for outcome data up to 90 days. The statistical trial report was completed and filed with the federal authorities in December 2023; additional analyses were completed in October 2024. The study was terminated prematurely due to low enrollment rates. Interventions: Protocol group patients received 20% albumin to maintain serum albumin levels of at least 3.0 g/dL for up to 28 days during their intensive care unit admission. The control group received standard fluid administration with crystalloids. Main Outcomes and Measures: The primary end point was 90-day mortality; secondary end points included 28-day, 60-day, intensive care unit and in-hospital mortality, organ dysfunction or failure, total amount of fluid administration and total fluid balance while in the intensive care unit, duration of intensive care and hospital stays, and frequency of adverse events. Results: Of 440 randomized patients (median [IQR] age, 69 [59-78] years; 290 [65.9%] male), 222 received albumin and 218 received standard fluids. Baseline characteristics were comparable. Ninety-day mortality was 43.3% (91 of 210) in the albumin group vs 45.9% (96 of 209) in controls (relative risk, 0.94; 95% CI, 0.76-1.17; P = .71). No significant differences were observed for secondary end points. Conclusions and Relevance: In this randomized clinical trial of patients with septic shock, albumin administration was safe but did not improve 90-day survival. As this trial was prematurely terminated, results remain inconclusive and additional studies are recommended. Trial Registration: ClinicalTrials.gov Identifier: NCT03869385.
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