Five percent albumin for adult burn shock resuscitation

Lack of effect on daily multiple organ dysfunction score

Andrew B. Cooper, Stephen M. Cohn, Haibo S. Zhang, Kim Hanna, Thomas E. Stewart, Arthur S. Slutsky

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

BACKGROUND: The effect of 5 percent human albumin on multiple organ dysfunction was investigated during the first 14 days of treatment to determine whether albumin resuscitation might benefit adult burn patients. STUDY DESIGN AND METHODS: Multicenter unblinded controlled trial with stratified block (two patients per block) randomization by center and mortality prediction at enrollment (high-risk stratum [predicted mortality, 50%-90%] and low-risk stratum [predicted mortality, <50%]). The primary outcome was the worst multiple organ dysfunction score (MODS), excluding the cardiovascular component, to Day 14. Eligible adults (>15 years) suffering from thermal injury not more than 12 hours before enrollment received fluid resuscitation with Ringer's lactate (n = 23) or 5 percent human albumin plus Ringer's lactate (n = 19) by protocol to achieve recommended (American Burn Association) resuscitation endpoints. RESULTS: Forty-two patients were randomly assigned. There were no significant differences (median [95% confidence intervals]) in age (36 [24-45] vs. 31 [25-39] years), burn size (39 [32-53] vs. 32 [26-34] total body surface area percentage), inhalation injury (n = 12/19 vs. n = 11/23), or baseline MODS (3 [1-5] vs. 1.5 [0-2]) between the treatment and control groups. In an intention-to-treat analysis, there was no significant difference between the treatment and control group in the lowest MODS from Day 0 to Day 14 (analysis of covariance, p = 0.73). CONCLUSION: Treatment with 5 percent albumin from Day 0 to Day 14 does not decrease the burden of MODS in adult burn patients.

Original languageEnglish (US)
Pages (from-to)80-89
Number of pages10
JournalTransfusion
Volume46
Issue number1
DOIs
StatePublished - Jan 2006
Externally publishedYes

Fingerprint

Organ Dysfunction Scores
Resuscitation
Multiple Organ Failure
Albumins
Shock
Mortality
Control Groups
Intention to Treat Analysis
Body Surface Area
Wounds and Injuries
Therapeutics
Random Allocation
Inhalation
Hot Temperature
Confidence Intervals
Ringer's lactate

ASJC Scopus subject areas

  • Hematology
  • Immunology

Cite this

Five percent albumin for adult burn shock resuscitation : Lack of effect on daily multiple organ dysfunction score. / Cooper, Andrew B.; Cohn, Stephen M.; Zhang, Haibo S.; Hanna, Kim; Stewart, Thomas E.; Slutsky, Arthur S.

In: Transfusion, Vol. 46, No. 1, 01.2006, p. 80-89.

Research output: Contribution to journalArticle

Cooper, Andrew B. ; Cohn, Stephen M. ; Zhang, Haibo S. ; Hanna, Kim ; Stewart, Thomas E. ; Slutsky, Arthur S. / Five percent albumin for adult burn shock resuscitation : Lack of effect on daily multiple organ dysfunction score. In: Transfusion. 2006 ; Vol. 46, No. 1. pp. 80-89.
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abstract = "BACKGROUND: The effect of 5 percent human albumin on multiple organ dysfunction was investigated during the first 14 days of treatment to determine whether albumin resuscitation might benefit adult burn patients. STUDY DESIGN AND METHODS: Multicenter unblinded controlled trial with stratified block (two patients per block) randomization by center and mortality prediction at enrollment (high-risk stratum [predicted mortality, 50{\%}-90{\%}] and low-risk stratum [predicted mortality, <50{\%}]). The primary outcome was the worst multiple organ dysfunction score (MODS), excluding the cardiovascular component, to Day 14. Eligible adults (>15 years) suffering from thermal injury not more than 12 hours before enrollment received fluid resuscitation with Ringer's lactate (n = 23) or 5 percent human albumin plus Ringer's lactate (n = 19) by protocol to achieve recommended (American Burn Association) resuscitation endpoints. RESULTS: Forty-two patients were randomly assigned. There were no significant differences (median [95{\%} confidence intervals]) in age (36 [24-45] vs. 31 [25-39] years), burn size (39 [32-53] vs. 32 [26-34] total body surface area percentage), inhalation injury (n = 12/19 vs. n = 11/23), or baseline MODS (3 [1-5] vs. 1.5 [0-2]) between the treatment and control groups. In an intention-to-treat analysis, there was no significant difference between the treatment and control group in the lowest MODS from Day 0 to Day 14 (analysis of covariance, p = 0.73). CONCLUSION: Treatment with 5 percent albumin from Day 0 to Day 14 does not decrease the burden of MODS in adult burn patients.",
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N2 - BACKGROUND: The effect of 5 percent human albumin on multiple organ dysfunction was investigated during the first 14 days of treatment to determine whether albumin resuscitation might benefit adult burn patients. STUDY DESIGN AND METHODS: Multicenter unblinded controlled trial with stratified block (two patients per block) randomization by center and mortality prediction at enrollment (high-risk stratum [predicted mortality, 50%-90%] and low-risk stratum [predicted mortality, <50%]). The primary outcome was the worst multiple organ dysfunction score (MODS), excluding the cardiovascular component, to Day 14. Eligible adults (>15 years) suffering from thermal injury not more than 12 hours before enrollment received fluid resuscitation with Ringer's lactate (n = 23) or 5 percent human albumin plus Ringer's lactate (n = 19) by protocol to achieve recommended (American Burn Association) resuscitation endpoints. RESULTS: Forty-two patients were randomly assigned. There were no significant differences (median [95% confidence intervals]) in age (36 [24-45] vs. 31 [25-39] years), burn size (39 [32-53] vs. 32 [26-34] total body surface area percentage), inhalation injury (n = 12/19 vs. n = 11/23), or baseline MODS (3 [1-5] vs. 1.5 [0-2]) between the treatment and control groups. In an intention-to-treat analysis, there was no significant difference between the treatment and control group in the lowest MODS from Day 0 to Day 14 (analysis of covariance, p = 0.73). CONCLUSION: Treatment with 5 percent albumin from Day 0 to Day 14 does not decrease the burden of MODS in adult burn patients.

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