• Praleene Sivapalan, Karen Louise Ellekjaer, Anders Perner, MøllerMorten HylanderMH0000-0002-6378-9673Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.Collaboration for Research in Intensive Care (CRIC), Copenhagen, Denmark.Department of Clinical Medicine, Faculty o, Anders Granholm, Lasse Grønningsæter, Marlies Ostermann, SweeneyRob MacRM0000-0002-1499-5016Department of Intensive care, Royal Victoria Hospital, Belfast, UK., Maria Cronhjort, Johanna Hästbacka, Carmen Pfortmueller, Jan De Waele, Marek Nalos, Tomas Jovaisa, Reintam BlaserAnnikaA0000-0003-1211-7372University of Tartu, Tartu, Estonia.Department of Intensive Care, Cantonal Hospital of Lucerne, Lucerne, Switzerland., Maurizio Cecconi, Begum Ergan, Abdulrahman Al-Fares, Paul J Young, Wojciech Szczeklik, Eric Keus, Fayez Alshamsi, Ashish K Khanna, Martin Ingi Sigurdsson, Tomoko Fujii, Yaseen M Arabi, and Tine Sylvest Meyhoff.
• Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
• Acta Anaesthesiol Scand. 2024 Oct 1; 68 (9): 123412431234-1243.

IntroductionUse of albumin is suggested for some patients with shock, but preferences for its use may vary among intensive care unit (ICU) physicians.MethodsWe conducted an international online survey of ICU physicians with 20 questions about their use of albumin and their opinion towards a randomised trial among adults with shock comparing the use versus no use of albumin.ResultsA total of 1248 respondents participated, with a mean response rate of 37%, ranging from 18% to 75% across 21 countries. Respondents mainly worked in mixed ICUs and 92% were specialists in intensive care medicine. The reported use of albumin in general shock varied as 18% reported 'almost never', 22% 'rarely', 34% 'occasionally', 22% 'frequently' and 4% 'almost always' using albumin. In septic shock, 19% reported 'almost never', 22% 'rarely', 29% 'occasionally', 22% 'frequently' and 7% 'almost always' using albumin. Physicians' preferences were more consistent for haemorrhagic- and cardiogenic shock, with more than 45% reporting 'almost never' using albumin. While the reported use of albumin for other purposes than resuscitation was infrequent (40%-85% reported 'almost never' for five other indications), the most frequent other indications were low serum albumin levels and improvement of the efficacy of diuretics. Most respondents (93%) would randomise adult ICU patients with shock to a trial of albumin versus no albumin.ConclusionsIn this international survey, the reported preferences for the use of albumin in adult ICU patients with shock varied considerably among surveyed ICU physicians. The support for a future randomised trial was high.© 2024 The Author(s). Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

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