Evidence map›Paper›PMID 9677209›Full record

SynthesisBMJ (Clinical research ed.)1998

Human albumin administration in critically ill patients: systematic review of randomised controlled trials.

Cochrane Injuries Group Albumin Reviewers

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 1998. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 187 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
187citing papers in PubMed, 17 pooled it
61.1field-weighted citation impact, top 1% of its field
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

187 citing papers in PubMed, 17 syntheses or guidelines pooled it, 1,088 citations in OpenAlex.

  1. Guideline
  2. Pooled it
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  4. Guideline
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  9. Guideline
  10. Recommendations for the use of albumin and immunoglobulins.Blood transfusion = Trasfusione del sangue · 2009
    Guideline
  11. Guideline
  12. Pooled it
  13. Guideline
  14. Guideline
  15. Pooled it
  16. Albumin infusion for low serum albumin in preterm newborn infants.The Cochrane database of systematic reviews · 2004
    Pooled it
  17. Albumin in Burn Shock Resuscitation: A Meta-Analysis of Controlled Clinical Studies.Journal of burn care & research : official publication of the American Burn Association
    Pooled it
  18. Trial
  19. Trial
  20. Trial

127 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

1 author at 1 institution in 1 country.

Cochrane Injuries Group Albumin ReviewersCochrane Injuries Group, Department of Epidemiology and Public Health, Institute of Child Health, London WC1N 1EH.
Institute of Child Health · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo quantify effect on mortality of administering human albumin or plasma protein fraction during management of critically ill patients.

designSystematic review of randomised controlled trials comparing administration of albumin or plasma protein fraction with no administration or with administration of crystalloid solution in critically ill patients with hypovolaemia, burns, or hypoalbuminaemia. SUBJECTS: 30 randomised controlled trials including 1419 randomised patients.

main outcome measureMortality from all causes at end of follow up for each trial.

resultsFor each patient category the risk of death in the albumin treated group was higher than in the comparison group. For hypovolaemia the relative risk of death after albumin administration was 1.46 (95% confidence interval 0.97 to 2.22), for burns the relative risk was 2.40 (1.11 to 5.19), and for hypoalbuminaemia it was 1.69 (1.07 to 2.67). Pooled relative risk of death with albumin administration was 1.68 (1.26 to 2.23). Pooled difference in the risk of death with albumin was 6% (95% confidence interval 3% to 9%) with a fixed effects model. These data suggest that for every 17 critically ill patients treated with albumin there is one additional death.

conclusionsThere is no evidence that albumin administration reduces mortality in critically ill patients with hypovolaemia, burns, or hypoalbuminaemia and a strong suggestion that it may increase mortality. These data suggest that use of human albumin in critically ill patients should be urgently reviewed and that it should not be used outside the context of rigorously conducted, randomised controlled trials.

Indexed as

AlbuminsBlood ProteinsBurnsColloidsCritical IllnessCrystallizationHumansRandomized Controlled Trials as TopicRisk FactorsSerum AlbuminShockAlbuminsBlood ProteinsColloidsSerum Albumin

Identifiers

PMID9677209
PMCPMC28613
OpenAlexW1554783366

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.