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Debate: Albumin administration should not be avoided. |
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Debate: Albumin administration
should not be avoided.
Allison SP,
Lobo DN. Crit Care 2000;4:14750
Clinical Nutrition Unit, University Hospital,
Queen's Medical Centre, Nottingham, UK.
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The recent Cochrane report on
albumin administration is analysed and criticised on the grounds of clinical
methodology, content and interpretation. Although it is naive and illogical to
treat hypoalbuminaemia with albumin infusions, a more balanced view on the use
of albumin for resuscitation in acute hypovolaemia is necessary. Once the acute
phase of critical illness is past, interstitial volume is often expanded causing
oedema, with a low plasma volume. We argue for the use of salt-poor albumin
solutions in this situation and conclude that, on current evidence, the
assertion that albumin should be avoided in all situations is irrational and
untenable.
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