albumin in major burns

Last reviewed 01/2018

As a protein colloid, albumin is widely used for burns resuscitation. It has the following advantages:

  • widely available
  • oncotically very active
  • no disease transmission

However, The Cochrane Injuries Group Albumin Reviewers published an interesting meta-analysis(1). They looked at 30 studies comparing the use of albumin with crystalloid resuscitation in three groups:

  • burns
  • hypovolaemia
  • hypoproteinaemia

Controversially, they found:

  • the risk of death was higher in those treated with albumin
  • the risk of death was greater for burns than hypoproteinaemia

However, the study has been criticized:

  • of the 30 studies, only 3 looked at burns patients
  • these studies were non-uniform in terms of indications and amount of albumin given
  • all three studies had less than 150 patients

Reference: The Cochrane Injuries Group Albumin Reviewers (1998), BMJ, 317(7153), 235-240.