A comparison of albumin and saline for fluid resuscitation in the intensive care unit.

Finfer S, Bellomo R, Boyce N, French J, Myburgh J, Norton R; SAFE Study Investigators
N Engl J Med 2004;350(22):2247-2256.
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Essential reading material. The largest PRCT of Albumin vs Saline in 7,000 critically ill patients in Australia and New Zealand. Concludes “no-difference” in 28 day mortality. Subset trends to excess mortality with Albumin in trauma and head injury (more intra-cerebral bleeds) and reduced mortality with Albumin in sepsis. For those of us that never use Albumin and/or Saline we may be left with more questions than answers. However, big take home message is that these trials can and should be done. Congratulations to the ANZICS study group on leading the way!

– Monty Mythen