Albumin replacement in patients with severe sepsis or septic shock

Pietro Caironi, Gianni Tognoni, Serge Masson, Roberto Fumagalli, Antonio Pesenti, Marilena Romero, Caterina Fanizza, Luisa Caspani, Stefano Faenza, Giacomo Grasselli, Gaetano Iapichino, Massimo Antonelli, Vieri Parrini, Gilberto Fiore, Roberto Latini, Luciano Gattinoni

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Abstract

BACKGROUND: Although previous studies have suggested the potential advantages of albumin administration in patients with severe sepsis, its efficacy has not been fully established. METHODS: In this multicenter, open-label trial, we randomly assigned 1818 patients with severe sepsis, in 100 intensive care units (ICUs), to receive either 20% albumin and crystalloid solution or crystalloid solution alone. In the albumin group, the target serum albumin concentration was 30 g per liter or more until discharge from the ICU or 28 days after randomization. The primary outcome was death from any cause at 28 days. Secondary outcomes were death from any cause at 90 days, the number of patients with organ dysfunction and the degree of dysfunction, and length of stay in the ICU and the hospital. RESULTS: During the first 7 days, patients in the albumin group, as compared with those in the crystalloid group, had a higher mean arterial pressure (P = 0.03) and lower net fluid balance (P

Original languageEnglish
Pages (from-to)1412-1421
Number of pages10
JournalNew England Journal of Medicine
Volume370
Issue number15
DOIs
Publication statusPublished - 2014

ASJC Scopus subject areas

  • Medicine(all)

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    Caironi, P., Tognoni, G., Masson, S., Fumagalli, R., Pesenti, A., Romero, M., Fanizza, C., Caspani, L., Faenza, S., Grasselli, G., Iapichino, G., Antonelli, M., Parrini, V., Fiore, G., Latini, R., & Gattinoni, L. (2014). Albumin replacement in patients with severe sepsis or septic shock. New England Journal of Medicine, 370(15), 1412-1421. https://doi.org/10.1056/NEJMoa1305727