Thursday November 24, 2005
Saline vs Albumin - SOAP trial

As we know that in SAFE trial (Saline vs Albumin Fluid Evaluation) there was some positive trend for albumin in severe sepsis subset patients but overall 28-days outcome was “no difference”. But this month results of SOAP (Sepsis Occurrence in Acutely ill Patients) study - with caution of various limitations to study - showed negative trend for albumin with conclusion: “Albumin administration was associated with decreased survival in this population of acutely ill patients”. Negative trend may be due to cardiac depression from decreased ionic calcium, impaired renal function and anti-thrombotic properties of albumin. Probably the real answer is bedside clinical judgement for each patient.

References: click to get abstract/article
1. A Comparison of Albumin and Saline for Fluid Resuscitation in the Intensive Care Unit - NEJM, May 2004 Volume 350:2247-2256
2. Is albumin administration in the acutely ill associated with increased mortality? Results of the SOAP study - Critical Care 2005, 9:R745-R754