Why did ICTMG develop a guideline for Albumin?

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Intravenous albumin is administered in a wide spectrum of clinical scenarios where serum albumin levels have been reduced by acute or chronic illnesses and/or where crystalloids are deemed ineffective. There are potential benefits and risks associated with the use of intravenous albumin. Very few indications have an evidence base that supports its routine use in clinical practice.

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This guideline provides evidence based recommendations for the appropriate use of albumin in specific patient populations where it is commonly prescribed. The recommendations apply to pediatric and adult patients undergoing cardiovascular surgery, kidney replacement therapy, treatment for complications of cirrhosis, or receiving support for critical illness (e.g., intensive care support, sepsis).

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How to access the ICTMG publication

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ICTMG's publications on albumin use include a clinical practice guideline and a systematic review of its use in cardiac and vascular surgeries.

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PROSPERO registration:

• Callum J, Shehata N, Landry D, Skubas N. The use of intravenous albumin in critically ill patients, patients with liver cirrhosis or dialysis dependent patients: a systematic review. PROSPERO: International prospective register of systematic reviews. 2019 CRD42019145152

• Shehata N, Skubas N, Callum J. In patients undergoing cardiothoracic surgery does the use of intravenous albumin compared to no intravenous albumin, crystalloids colloid, gelatin, or hydroxyethyl starch reduce mortality, multisystem organ failure, renal failure, need or duration of renal replacement therapy or mechanical ventilation, or length of stay in the ICU or hospital? PROSPERO: International prospective register of systematic reviews 2020 CRD42020171876 

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Systematic review

• Skubas NJ, Callum J, Bathla A, Keshavarz H, Fergusson D, Wu B, Stanworth S, Shehata N; International Collaboration for Transfusion Medicine Guidelines. Intravenous albumin in cardiac and vascular surgery: a systematic review and meta-analysis. Br J Anaesth. 2023 Dec 14:S0007-0912(23)00630-X.

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Guideline:  

• Callum J, Skubas NJ, Bathla A, Keshavarz H, Clark EG, Rochwerg B, Fergusson D, Arbous S, Bauer SR, China L, Fung M, Jug R, Neill M, Paine C, Pavenski K, Shah PS, Robinson S, Shan H, Szczepiorkowski ZM, Thevenot T, Wu B, Stanworth S, Shehata N, on behalf of the ICTMG Intravenous Albumin Guideline Group, Use of Intravenous Albumin: A Guideline from the International Collaboration for Transfusion Medicine Guidelines., CHEST (2024), doi: 10.1016/j.chest.2024.02.049

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