TY - JOUR
T1 - Use of Intravenous Albumin
T2 - A Guideline From the International Collaboration for Transfusion Medicine Guidelines
AU - Callum, Jeannie
AU - Skubas, Nikolaos J.
AU - International Collaboration for Transfusion Medicine Guidelines Intravenous Albumin Guideline Group
AU - Bathla, Aarti
AU - Keshavarz, Homa
AU - Clark, Edward G.
AU - Rochwerg, Bram
AU - Fergusson, Dean
AU - Arbous, Sesmu
AU - Bauer, Seth R.
AU - China, Louise
AU - Fung, Mark
AU - Jug, Rachel
AU - Neill, Michael
AU - Paine, Cary
AU - Pavenski, Katerina
AU - Shah, Prakesh S.
AU - Robinson, Susan
AU - Shan, Hua
AU - Szczepiorkowski, Zbigniew M.
AU - Thevenot, Thierry
AU - Wu, Bovey
AU - Stanworth, Simon
AU - Shehata, Nadine
AU - Flores, Jerome
AU - Frappier, Stéfanie
AU - Hou, Yvette
AU - Jean-Pierre, Lilly
AU - Jomaa, Danny
AU - Kabir, Monisha
AU - Kadota, Leo
AU - Lam, Michelle
AU - Ripsman, David A.
AU - Sandarage, Ryan
AU - Staykov, Emiliyan
AU - Venes, Angelica
AU - Wan, Melissa
AU - Al Riyami, Arwa
AU - Allard, Shubha
AU - Brouwers, Melissa
AU - Daly, James
AU - Denomme, Gregory A.
AU - Estcourt, Lise
AU - Green, Laura
AU - Greinacher, Andreas
AU - Hume, Heather
AU - Kaufman, Richard
AU - Kim, Hyungsuk
AU - Louw, Vernon
AU - Matsushita, Tadashi
AU - So-Osman, Cynthia
N1 - Publisher Copyright:
© 2024 The Author(s)
PY - 2024/8
Y1 - 2024/8
N2 - Background: Albumin is used commonly across a wide range of clinical settings to improve hemodynamics, to facilitate fluid removal, and to manage complications of cirrhosis. The International Collaboration for Transfusion Medicine Guidelines developed guidelines for the use of albumin in patients requiring critical care, undergoing cardiovascular surgery, undergoing kidney replacement therapy, or experiencing complications of cirrhosis. Study Design and Methods: Cochairs oversaw the guideline development process and the panel included researchers, clinicians, methodologists, and a patient representative. The evidence informing this guideline arises from a systematic review of randomized clinical trials and systematic reviews, in which multiple databases were searched (inception through November 23, 2022). The panel reviewed the data and formulated the guideline recommendations using Grading of Recommendations Assessment, Development, and Evaluation methodology. The guidelines were revised after public consultation. Results: The panel made 14 recommendations on albumin use in adult critical care (three recommendations), pediatric critical care (one recommendation), neonatal critical care (two recommendations), cardiovascular surgery (two recommendations), kidney replacement therapy (one recommendation), and complications of cirrhosis (five recommendations). Of the 14 recommendations, two recommendations had moderate certainty of evidence, five recommendations had low certainty of evidence, and seven recommendations had very low certainty of evidence. Two of the 14 recommendations suggested conditional use of albumin for patients with cirrhosis undergoing large-volume paracentesis or with spontaneous bacterial peritonitis. Twelve of 14 recommendations did not suggest albumin use in a wide variety of clinical situations where albumin commonly is transfused. Interpretation: Currently, few evidence-based indications support the routine use of albumin in clinical practice to improve patient outcomes. These guidelines provide clinicians with actionable recommendations on the use of albumin.
AB - Background: Albumin is used commonly across a wide range of clinical settings to improve hemodynamics, to facilitate fluid removal, and to manage complications of cirrhosis. The International Collaboration for Transfusion Medicine Guidelines developed guidelines for the use of albumin in patients requiring critical care, undergoing cardiovascular surgery, undergoing kidney replacement therapy, or experiencing complications of cirrhosis. Study Design and Methods: Cochairs oversaw the guideline development process and the panel included researchers, clinicians, methodologists, and a patient representative. The evidence informing this guideline arises from a systematic review of randomized clinical trials and systematic reviews, in which multiple databases were searched (inception through November 23, 2022). The panel reviewed the data and formulated the guideline recommendations using Grading of Recommendations Assessment, Development, and Evaluation methodology. The guidelines were revised after public consultation. Results: The panel made 14 recommendations on albumin use in adult critical care (three recommendations), pediatric critical care (one recommendation), neonatal critical care (two recommendations), cardiovascular surgery (two recommendations), kidney replacement therapy (one recommendation), and complications of cirrhosis (five recommendations). Of the 14 recommendations, two recommendations had moderate certainty of evidence, five recommendations had low certainty of evidence, and seven recommendations had very low certainty of evidence. Two of the 14 recommendations suggested conditional use of albumin for patients with cirrhosis undergoing large-volume paracentesis or with spontaneous bacterial peritonitis. Twelve of 14 recommendations did not suggest albumin use in a wide variety of clinical situations where albumin commonly is transfused. Interpretation: Currently, few evidence-based indications support the routine use of albumin in clinical practice to improve patient outcomes. These guidelines provide clinicians with actionable recommendations on the use of albumin.
UR - http://www.scopus.com/inward/record.url?scp=85193368044&partnerID=8YFLogxK
U2 - 10.1016/j.chest.2024.02.049
DO - 10.1016/j.chest.2024.02.049
M3 - Article
C2 - 38447639
AN - SCOPUS:85193368044
SN - 0012-3692
VL - 166
SP - 321
EP - 338
JO - Chest
JF - Chest
IS - 2
ER -