Albumin infusion for low serum albumin in preterm newborn infants

Jardine, Luke A., Jenkins-Manning, Sue and Davies, Mark W. (2004) Albumin infusion for low serum albumin in preterm newborn infants. Cochrane Database of Systematic Reviews, 3 . doi:10.1002/14651858.CD004208.pub2

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Author Jardine, Luke A.
Jenkins-Manning, Sue
Davies, Mark W.
Title Albumin infusion for low serum albumin in preterm newborn infants
Journal name Cochrane Database of Systematic Reviews   Check publisher's open access policy
ISSN 1469-493X
Publication date 2004
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1002/14651858.CD004208.pub2
Open Access Status File (Author Post-print)
Volume 3
Place of publication Oxford, United Kingdom
Publisher John Wiley & Sons
Language eng
Subject 321019 Paediatrics
C1
Formatted abstract
Background: Intravenous albumin infusion is used to treat hypoalbuminaemia in critically ill infants. Hypoalbuminaemia occurs in a number of clinical situations including prematurity, the acutely sick infant, respiratory distress syndrome (RDS), chronic lung disease (CLD), necrotising enterocolitis (NEC), intracranial haemorrhage, hydrops fetalis and oedema. Fluid overload is a potential side effect of albumin administration. Albumin is a blood product and therefore carries the potential risk of infection and adverse reactions. Albumin is also a scarce and expensive resource.

Objectives: The primary objective was to assess the effect of albumin infusions on morbidity and mortality in preterm neonates with low serum albumin. A secondary objective was to assess whether albumin infusion is associated with significant side effects.

Search strategy
: Searches were made of MEDLINE from 1966 to December 2006, CINAHL from 1982 to December 2006 and the current Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 4, 2006). Previous reviews (including cross references) and abstracts were also searched.

Selection criteria: All randomised and quasi randomised controlled trials in which individual patients were allocated to albumin infusion versus control were included. Cross-over studies were excluded. Participants were preterm infants who had hypoalbuminaemia. Types of interventions included albumin infusion versus placebo (e.g. crystalloid) or no treatment.

Data collection and analysis
: The reviewers worked independently to search for trials for inclusion and to assess methodological quality. Studies were assessed using the following key criteria: blinding of randomisation, blinding of intervention, completeness of follow up and blinding of outcome measurement.

Main results: Only two small studies were found for inclusion in this review and only one reported clinically relevant outcomes. This study found no significant differences for the primary outcome measure of death (RR 1.5 [95% confidence interval 0.3 - 7.43]) or secondary outcome measures of intraventricular haemorrhage, patent ductus arteriosus, necrotising enterocolitis, bronchopulmonary dysplasia, duration of mechanical ventilation and duration of oxygen therapy.

Authors' conclusions
: There is a lack of evidence from randomised trials to determine whether the routine use of albumin infusion, in preterm neonates with low serum albumin, reduces mortality or morbidity, and no evidence to assess whether albumin infusion is associated with significant side effects. There is a need for good quality, double-blind randomised controlled trials to assess the safety and efficacy of albumin infusions in preterm neonates with low serum albumin.

Plain language summary
: There is a lack of evidence from randomised trials to either support or refute the routine use of albumin infusion for premature babies with a low albumin level. Albumin is a protein that is normally present in the blood. In premature infants, the albumin level in the blood can be low. Albumin is often given to premature babies with a low albumin level. Only two small randomised controlled trials have studied the use of albumin in sick premature babies, and the trials are not big enough or good enough to decide whether giving albumin helps babies in the short or long term. Therefore, the question of whether giving albumin does any good and is safe cannot be answered.
Keyword Albumin
Hypoalbuminemia
Infant
Premature
Newborn
Q-Index Code C1
Q-Index Status Provisional Code
Additional Notes This record should be cited as: Jardine LA, Jenkins-Manning S, Davies MW. Albumin infusion for low serum albumin in preterm newborn infants. Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD004208. DOI: 10.1002/14651858.CD004208.pub2. This version first published online: 19 July 2004 in Issue 3, 2004.

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Excellence in Research Australia (ERA) - Collection
2006 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Thu, 19 Oct 2006, 10:00:00 EST by Carly Barrett on behalf of School of Medicine