Human albumin 4% versus hydroxyethyl starch 6% for fluid resuscitation in sepsis

H. Toulan, E. Kamal
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Abstract

Background Early fluid resuscitation is vital to patients with sepsis. However, the choice of fluid has been a hot topic of discussion. The objective of this study was to compare hydroxyethyl starch (HES) 6% (130/0.4) with albumin 4% as a resuscitation fluid in septic patients. Patients and methods In this prospective randomized study, 80 patients aged 20–60 years of both sexes with sepsis were assigned to receive either HES (130/0.4) in 0.9% saline or human albumin 4% as a resuscitation fluid. Mortality rate after 28 days, need for renal replacement therapy, and duration of ICU stay were compared between the two groups. Results The mortality rate in the albumin group (22.5%) was lower than in the HES 6% group (40%) with significant P value (0.033). Also, the need for renal replacement therapy (RRT) and length of ICU stay were significantly higher in the HES 6% group compared with the albumin group. Conclusion Use of human albumin 4% has a significant effect in reducing mortality rates in the ICU in patients with severe sepsis compared with HES 6%.
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人白蛋白4%与羟乙基淀粉6%对败血症患者液体复苏的影响
背景:早期液体复苏对脓毒症患者至关重要。然而,流体的选择一直是讨论的热点话题。本研究的目的是比较6%的羟乙基淀粉(HES)(130/0.4)和4%的白蛋白作为败血症患者的复苏液。患者和方法在这项前瞻性随机研究中,80名年龄在20-60岁的男女败血症患者被分配接受HES(130/0.4), 0.9%生理盐水或4%人白蛋白作为复苏液。比较两组患者术后28天死亡率、肾脏替代治疗需求及ICU住院时间。结果白蛋白组死亡率(22.5%)低于HES 6%组(40%),差异有统计学意义(P值为0.033)。此外,与白蛋白组相比,HES 6%组对肾脏替代治疗(RRT)的需求和ICU住院时间明显更高。结论在ICU重症脓毒症患者中,使用4%的人白蛋白比使用6%的人白蛋白有显著的降低死亡率的效果。
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