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Burn patient characteristics and outcomes following resuscitation with albumin. |
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Burn patient characteristics and outcomes following resuscitation with albumin.
Burns. 2007 Feb;33(1):25-30.
Cochran A, Morris SE, Edelman LS, Saffle JR.
Burn
Center at the University of Utah, Department of Surgery, University of
Utah Health Sciences Center, Salt Lake City, UT, United States.
BACKGROUND:
Use of colloids in acute burn resuscitation may reduce fluid
requirements, but effect on mortality is unknown. We hypothesized that
patients who received albumin would have similar mortality to patients
who did not receive albumin. METHODS: We performed a case-controlled
study of inpatients who sustained burns of >/=20% total body surface
area (TBSA).
Patients who received albumin during resuscitation because
of increased fluid requirements (ALB) were compared to a cohort of
patients matched for age and TBSA who did not receive albumin (CON).
RESULTS: Patients with inhalation injury were significantly more likely
to receive albumin (OR 4.89, 95% CI 2.58-9.30). ALB patients had
significantly higher mean initial lactate (3.64 versus 2.29, p=0.01),
longer mean time to resuscitation (52.8h versus 36.3h; p=0.001), and
higher resuscitation volume (9.4mL/kg/%TBSA versus 6.4mL/kg/%TBSA for
CON). Mortality was not significantly different between the two groups
(OR 1.90, 95% CI 0.85-4.22). Albumin was protective in a multivariate
model of mortality (OR 0.27, 95% CI 0.07-0.97). CONCLUSIONS: Despite
more severe systemic dysfunction, burn patients who received albumin
did not suffer increased mortality. A novel finding is the decreased
likelihood of mortality associated with the administration of albumin
during burn resuscitation.
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