Debate: Albumin administration should not be avoided

The recent Cochrane report on albumin administration is analysed and critic ised on the grounds of clinical methodology, content and interpretation. Al though it is naive and illogical to treat hypoalbuminaemia with albumin inf usions, a more balanced view on the use of albumin for resuscitation in acu te hypovolaemia is necessary. Once the acute phase of critical illness is p ast, interstitial volume is often expanded causing oedema, with a low plasm a volume. We argue for the use of salt-poor albumin solutions in this situa tion and conclude that, on current evidence, the assertion that albumin sho uld be avoided in all situations is irrational and untenable.