Immediate Reduction in Hospital Pharmacy Costs with #Intraoperative Restriction of Albumin Administration by Enrico Camporesi in BJSTR
Abstract
Albumin has been used for fluid resuscitation in the OR and ICU,
since 1940 [1]. Its usage gained prominence based on the classic
descriptions of transvascular exchange by Earnest Starling who
purported that colloids such as albumin should be more effective
at increasing depleted intravascular volume due to their relative
vascular membrane impermeability when compared to crystalloids
such as saline [2]. It was not until 1998 that a systematic review
by the Cochrane Injury Group Albumin Reviewers that the use of
albumin for fluid resuscitation came under scrutiny [3]. In this first
summary they described a 6 percent increase in mortality (relative
risk 1.68, 95% confidence interval 1.28 to 2.23) in patients with
hypovolemia, burns, and hypo-albuminemia who received albumin
versus other fluids. This scrutiny lead to the landmark Saline versus
Albumin Fluid Evaluation (SAFE) study published in the New
England Journal of Medicine [4].
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.