Evidence supporting the use of: Albumin
For the health condition: Hypotension

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Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Albumin is used in the management of hypotension, particularly in the context of hypovolemia or shock, and its use is supported by scientific evidence in specific clinical scenarios. Albumin is a plasma protein that exerts oncotic pressure, helping to retain fluid within the vasculature. In cases of hypotension due to low circulating blood volume (such as in sepsis, burns, or after major surgery), intravenous albumin can help restore intravascular volume and improve blood pressure. Clinical guidelines, such as those from the Surviving Sepsis Campaign and other critical care societies, recognize albumin as a resuscitation fluid in patients with sepsis or septic shock, especially when large volumes of crystalloids alone are insufficient.

However, the overall benefit of albumin compared to crystalloids for fluid resuscitation in hypotensive patients remains a topic of research and debate. Large trials such as the SAFE study (NEJM, 2004) found no significant difference in mortality between albumin and saline for fluid resuscitation in critically ill patients. Subgroup analyses suggest possible benefit in patients with septic shock. Albumin is also used when patients are hypoalbuminemic or when fluid overload is a concern, due to its oncotic properties. While albumin is not first-line therapy for hypotension in all settings, its use is scientifically validated in specific patient populations and is included in clinical guidelines for those scenarios.

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