A Comment on a Meta-analysis That Suggests Efficacy of Albumin in Burn Shock Resuscitation
The “before” and “after” studies3,4 labeled as “non-albumin” vs “albumin” misrepresent the underlying data. Neither background publication has information for the subset of patients who received albumin compared with those who did not. In the article by Park et al3, 59% of patients represented herein as “albumin” patients did not actually receive colloid therapy. The article by Ennis et al4 does not state the fraction of patients who received albumin. These nonrandomized studies provide the majority of the weight in Figures 1 and 2, and inferences from these analyses are therefore limited.
In a prior meta-analyses, burn patients demonstrated increase in mortality when treated with albumin (OR = 1.765; 95% CI: 0.97–3.17 and OR = 2.46; 95% CI: 1.11–5.19) vs non-albumin-treated patients. The added studies are not high enough quality to reverse this trend.
The author would like to thank Dr. Christine N Yost, PharmD, and Dr. Alison Paplaskas, PharmD, for their review and comments.
This letter to the editor discusses the use of albumin off-label for the resuscitation of burn shock patients. This discussion is in reference to original articles and their analysis of this off-label use.