Should albumin be used as initial resuscitation strategy in septic patients who need vasopressor support?
I´ve personally changed my opinion about albumin and i think that we have "some evidence" after ALBIOS study to recomend its use in septic shock patients. However i´m not sure if i would start with albumin overload or i would probably try crystalloids first?
To me, I prefer giving iv. albumin when the septic shock patients exhibit refractory shock after adequate fluid loading of isotonic crystalloid (may be more than 30 mL/kg), and I even give albumin faster in previous hypoalbuminemic case. Although the ALBIOS study demonstrated that albumin had no survival benefit, the patients receiving albumin group had a "trend" of lower positive fluid balance, compared to control group. Also, compared to crystalloid, there is no evidence of harmful of albumin infusion in septic shock patients.
Thank you Dr Wacharasint for your answer. Just consider that in septic shock subgroup albumin infusion was associated with better outcome.
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