EFFICACY OF ALBUMIN SUPPLEMENTATION IN THE SURGICAL INTENSIVE-CARE UNIT - A PROSPECTIVE, RANDOMIZED STUDY

Objective: To determine the efficacy of supplemental 25% albumin in re ducing morbidity and mortality rates in the surgical intensive care un it (ICU). Design: Prospective, randomized, unblinded clinical study. S etting: Surgical ICU in a community hospital. Patients: Two hundred ni neteen patients with admission circulating albumin concentrations of < 3.0 g/dL (<30 g/L). The groups were well matched regarding age, sex, A cute Physiology and Chronic Health Evaluation II scores and initial ci rculating albumin concentrations. Interventions: The treatment group ( n = 116) received 37.5 g/day of albumin until the circulating albumin concentration increased to >3.0 g/dL (>30 g/L). The control group (n = 103) received no supplemental albumin. Both groups received standard nutritional support. Measurements and Main Results: The complication r ate was 44% in the albumin group vs. 36.9% in the controls (p =.29). T he albumin patients had a mortality rate of 10.3% vs. 5.8% in the cont rol group (p =.22). There were no significant differences between the groups in the number of days spent receiving mechanical ventilation or in the tolerance to tube feedings. Conclusions: Routine supplemental administration of 25% albumin is expensive and offers no apparent outc ome advantage and should be abandoned in the treatment of patients in the surgical ICU.