• Clarice Hyesuk Lee Park, de Almeida Juliano Pinheiro JP Department of Intensive Care, Cancer Institute, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil., Gisele Queiroz de Oliveira, Stéphanie Itala Rizk, Julia Tizue Fukushima, Rosana Ely Nakamura, Matheus Moraes Mourão, Galas Filomena Regina Barbosa Gomes FRBG Division of Anesthesia, Heart Institute, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil., Edson Abdala, Pinheiro Freire Maristela M Department of Infectious Diseases, Cancer Institute, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil., Roberto Kalil Filho, Costa Auler Jose Otavio JO Jr Division of Anesthesia, Heart Institute, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil., Pasquale Nardelli, Greg S Martin, Giovanni Landoni, and Ludhmila Abrahao Hajjar.
• Department of Intensive Care, Cancer Institute, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
• Crit. Care Med. 2019 Oct 1; 47 (10): e798-e805.

ObjectiveTo investigate the effects of the administration of 4% albumin on lactated Ringer's, when compared with lactated Ringer's alone, in the early phase of sepsis in cancer patients.DesignSingle-center, randomized, double-blind, controlled-parallel trial.SettingA tertiary care university cancer hospital.PatientsCancer patients with severe sepsis or septic shock.InterventionsBetween October 2014 and December 2016, patients were randomly assigned to receive either bolus of albumin in a lactated Ringer's solution or lactated Ringer's solution alone during the first 6 hours of fluid resuscitation after intensive care medicine (ICU) admission. Primary outcome was defined as death from any cause at 7 days. Secondary outcomes were defined as death from any cause within 28 days, change in Sequence Organ Failure Assessment scores from baseline to day 7, days alive and free of mechanical ventilation, days alive and free of vasopressor, renal replacement therapy during ICU stay, and length of ICU and hospital stay.Measurements And Main ResultsA total of 360 patients were enrolled in the trial. At 7 days, 46 of 180 patients (26%) died in the albumin group and 40 of 180 (22%) died in the lactated Ringer's group (p = 0.5). At 28 days, 96 of 180 patients (53%) died in the albumin group and 83 of 180 (46%) died in the lactated Ringer's group (p = 0.2). No significant differences in secondary outcomes were observed.ConclusionsAdding albumin to early standard resuscitation with lactated Ringer's in cancer patients with sepsis did not improve 7-day survival.

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