Randomised trials of human albumin for adults with sepsis: systematic review and meta-analysis with trial sequential analysis of all-cause mortality

An analysis of 16 RCTs (n=4190) found no statistically significant survival benefit from using albumin as part of fluid volume expansion and resuscitation for sepsis, severe sepsis, and septic shock.

The study authors note that their findings were robust to sensitivity, subgroup, meta-regression, and trial sequential analyses. Despite the lack of mortality benefit, no harm with albumin use was found.

 

An accompanying editorial notes that based on these findings, there is little justification for using human albumin rather than an isotonic crystalloid as a volume expander in patients with septic shock. New randomised controlled trial data are required to address whether fluid resuscitation is beneficial for people in septic shock.