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Immediate Reduction in Hospital Pharmacy Costs with Intraoperative Restriction of Albumin Administration

Volume 1 - Issue 6

Devanand Mangar, Garrett Enten and Enrico Camporesi*

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    • TEAM Health Anesthesia Research Institute, Tampa

    *Corresponding author: Enrico Camporesi, TEAM Health Research Institute, 1 Tampa general Circle Suite A327, Tampa, FL 33606

Received: November 03, 2017;   Published: November 13, 2017

DOI: 10.26717/BJSTR.2017.01.000520

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Abstract

Albumin has been used for fluid resuscitation in the OR and ICU, since 1940 [1]. Its usage gained prominence based on the classic descriptions of transvascular exchange by Earnest Starling who purported that colloids such as albumin should be more effective at increasing depleted intravascular volume due to their relative vascular membrane impermeability when compared to crystalloids such as saline [2]. It was not until 1998 that a systematic review by the Cochrane Injury Group Albumin Reviewers that the use of albumin for fluid resuscitation came under scrutiny [3]. In this first summary they described a 6 percent increase in mortality (relative risk 1.68, 95% confidence interval 1.28 to 2.23) in patients with hypovolemia, burns, and hypo-albuminemia who received albumin versus other fluids. This scrutiny lead to the landmark Saline versus Albumin Fluid Evaluation (SAFE) study published in the New England Journal of Medicine [4].

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