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

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Albumin is a plasma protein solution used clinically as a volume expander in the treatment of various types of shock, especially hypovolemic shock (such as from blood loss or severe burns). The rationale is that albumin, being a colloid, remains in the intravascular space and exerts oncotic pressure, thereby drawing fluid into the circulation and improving blood volume and pressure. However, scientific validation for the routine use of albumin in shock is mixed. Several large randomized controlled trials, including the SAFE (Saline versus Albumin Fluid Evaluation) study, have shown that albumin is no more effective than crystalloids (like saline) in reducing mortality in critically ill patients with shock. In certain subgroups, such as patients with septic shock or traumatic brain injury, results are conflicting or suggest possible harm. Guidelines from organizations such as the Surviving Sepsis Campaign generally recommend crystalloids as the initial fluid of choice, with albumin considered only in cases where substantial amounts of crystalloids are required. While albumin is FDA-approved and has a clear mechanism of action for volume expansion, the overall strength of evidence supporting its superiority in shock is moderate at best, and its use is typically reserved for specific situations rather than routine management.

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