Randomised comparison of fluid resuscitation with human albumin solution or normal saline among critically ill patients

Funded Activity Summary

Human albumin solution is widely used for the emergency treatment of severely ill patients requiring fluid replacement, both in Australia and worldwide. However, a recent report suggests that compared to the other standard treatment (salt solution), the use of human albumin solution may be associated with a higher death rate (about six additional deaths among every one hundred patients treated). But, this report was based on data from a relatively small number of patients among whom there was a relatively small number of deaths, and there is widespread uncertainty among doctors about the reliability of the evidence and the implications for patient care. This is reflected in the large difference between intensive care units in the use of human albumin solution (in Australia, its use ranges from 10-90% of all patients needing fluid). Human albumin solution costs, about thirty times more than salt solution, and during 1998 more than 200,000 bottles of human albumin solution were administered to patients in Australia, at a cost of about A$35 million. In an effort to provide definitive evidence about the effects (and cost-effectiveness) of fluid replacement with human albumin solution, the Australia and New Zealand Intensive Care Society, in collaboration with the Australian Red Cross Blood Services and the Institute for International Health, has proposed the conduct of new large-scale study (SAFE - Saline vs Albumin Fluid Evaluation). This study will involve 7,000 patients from 15 intensive care units in Australia and New Zealand. These patients (all of whom require fluid replacement) will be randomly assigned to receive either human albumin solution or salt solution and outcome in terms of deaths and other serious events will be monitored over 28 days. Results will be available within 2 years of starting the study, and these are likely to influence the care of the majority of seriously ill patients admitted to intensive care units worldwide.

Funded Activity Details

Start Date: 01-01-2001

End Date: 01-01-2003

Funding Scheme: NHMRC Project Grants

Funding Amount: $611,728.00

Funder: National Health and Medical Research Council

Research Topics

ANZSRC Field of Research (FoR)

Intensive Care

ANZSRC Socio-Economic Objective (SEO)

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Other Keywords

Human albumin solution | Hypovolaemia | Injury | Intensive care | Normal saline | Randomised trial | Resuscitation

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