• Yan Zou, Ke Ma, Ji-Bin Xiong, Cai-Hua Xi, and Xiao-Jun Deng.
• MD. Associate Professor, Department of Intensive Care Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
• Sao Paulo Med J. 2018 Sep 1; 136 (5): 421432421-432.

BackgroundThis study aimed to compare the effects on mortality of albumin and crystalloid, used for fluid resuscitation among adult patients with septic shock, through conducting a meta-analysis and trial sequential analysis (TSA).Design And SettingMeta-analysis and TSA conducted at Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.MethodsData were collected from several major databases including MEDLINE, EMBASE, Clinical Trials.gov and Cochrane Central Register of Controlled Trials. Studies that compared the effects of albumin therapy versus crystalloid therapy on mortality among adult septic shock patients were eligible for inclusion in the analyses. The study name, year of publication, country of the trial, albumin concentration, type of crystalloid and all reported mortalities at different follow-up endpoints were extracted.ResultsCompared with crystalloid, albumin did not decrease all-cause mortality at the final follow-up. However, in TSA, the required information size was not achieved in all groups, which means that the effect size was not definitive and further RCTs are needed to confirm or deny these findings.ConclusionsCompared with crystalloid solutions, albumin was unable to decrease all-cause mortality. However, TSA indicated that these results could be false-negative. Additional randomized controlled trials are needed to clarify this discrepancy.

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