albumin in major burns
Last reviewed 01/2018
As a protein colloid, albumin is widely used for burns resuscitation. It has the following advantages:
- widely available
- oncotically very active
- no disease transmission
However, The Cochrane Injuries Group Albumin Reviewers published an interesting meta-analysis(1). They looked at 30 studies comparing the use of albumin with crystalloid resuscitation in three groups:
- burns
- hypovolaemia
- hypoproteinaemia
Controversially, they found:
- the risk of death was higher in those treated with albumin
- the risk of death was greater for burns than hypoproteinaemia
However, the study has been criticized:
- of the 30 studies, only 3 looked at burns patients
- these studies were non-uniform in terms of indications and amount of albumin given
- all three studies had less than 150 patients
Reference: The Cochrane Injuries Group Albumin Reviewers (1998), BMJ, 317(7153), 235-240.