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The following is a summary of “Use of Intravenous Albumin: A Guideline from the International Collaboration for Transfusion Medicine Guidelines,” published in the March 2024 issue of Pulmonology by Callum et al.
Albumin is a ubiquitous intervention in diverse clinical scenarios, optimizing hemodynamics, facilitating fluid management, and addressing complications associated with cirrhosis. The International Collaboration for Transfusion Medicine Guidelines meticulously crafted recommendations for albumin administration across critical care, cardiovascular surgery, kidney replacement therapy, and cirrhosis-related complications. The guideline development process, overseen by co-chairs and comprising a multidisciplinary panel including researchers, clinicians, methodologists, and a patient representative, meticulously synthesized evidence from a comprehensive systematic review of randomized clinical trials and systematic reviews spanning multiple databases up to November 23, 2022. Utilizing the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology, the panel deliberated over the data to formulate robust recommendations, subsequently refined through public consultation.
The resultant guidelines encompass 14 recommendations for adult, pediatric, and neonatal critical care, cardiovascular surgery, kidney replacement therapy, and cirrhosis-related complications. Notably, the certainty of evidence varied across recommendations, with the majority resting on low to very low levels of certainty. Among the recommendations, conditional use of albumin was proposed for specific scenarios such as large-volume paracentesis or spontaneous bacterial peritonitis in cirrhotic patients. However, the overarching consensus underscored limited evidence supporting routine albumin administration across various clinical contexts where its use is prevalent. Consequently, these guidelines offer actionable insights for clinicians, advocating judicious consideration of albumin utilization in alignment with evidence-based practice to optimize patient outcomes.
Source: sciencedirect.com/science/article/pii/S001236922400285X