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Table 2 Systematic reviews and meta-analyses on albumin use as a resuscitation fluid in sepsis/septic shock

From: Hemodynamic support in the early phase of septic shock: a review of challenges and unanswered questions

Systematic reviews [ref.] No. of patients (n) No. of RCTs included (presented) Intervention fluid therapy Primary outcome Results: albumin versus crystalloids Comments
Bansal et al. [50] 6082 13 (6) Albumin, crystalloids [HES] Mortality *OR 0.9 (0.8–1.01) 2 RCTs including children and 1 case mix
     RRT need ? 7 RCTs with specific comparison HES versus crystalloids
Xu et al. [51] 5838 5 Albumin, crystalloids All-cause mortality ** OR 0.88 (0.76–1.01) p = 0.08 severe sepsis
OR 0.81 (0.67–0.97) p = 0.03 Septic shock
4 of 5 RCTs not entirely dedicated to septic patients
Patel et al. [52] 4190 16 Albumin, crystalloids All-cause mortality RR 0.93 (0.86–1.01) p = 0.07 ~ 10 RCTs not entirely dedicated to septic patients
Rochwerg [53] 1238†† 14 (2) Albumin, crystalloids All-cause mortality NMA 0.83 (0.65–1.04) estimate Only 2 RCTs with direct comparison and one multicentric subgroup analysis encompassing more than 98%
  1. RCTS randomized control trials, OR odds ratio, RR relative risk, HES hydroxy ethyl starches, NMA nodal meta-analysis
  2. *28- and 30-day mortality
  3. **90-day mortality
  4. One EARSS from the reported conference proceedings
  5. ††Post hoc analyses: (1) ALBIOS trial patients (n = 1815) not included because Alb was not used as a resuscitation fluid; data incorporation did not affect the final results, (2) exclusion of data from the one trial encompassing less than 2% of patients did not affect the final results