MAINTENANCE OF SERUM-ALBUMIN LEVELS IN PEDIATRIC BURN PATIENTS - A PROSPECTIVE, RANDOMIZED TRIAL

A prospective, randomized trial was performed to determine whether mai ntaining serum albumin levels in burned pediatric patients had any eff ect on morbidity and mortality, Patients <19 years of age with burns > 20% total body surface area were randomized to receive supplemental al bumin to maintain levels 2.5 to 3.5 g/dL (''High Albumin'') or were gi ven albumin only if levels dropped <1.5 g/dL (''Low Albumin'') after c ompleting burn shock resuscitation. The 36 patients in the Low Albumin group were well matched for age, burn size, depth of injury, and inha lation injury when compared with the High Albumin group (34 patients), As expected, serum albumin levels were significantly lower in the Low Albumin group when compared with the High Albumin group, No differenc es between groups were noted for resuscitation needs, maintenance flui d requirements, urine output, tube feedings received, days of antibiot ic treatment, or ventilatory requirements, No differences in hematolog y, electrolytes, or nutritional laboratories were found, Finally, leng th of stay, complication rate, and mortality were not affected by albu min treatment, Albumin supplementation to maintain normal serum levels does not seem to be warranted in previously healthy children who suff er severe burns and who receive adequate nutrition.