Use of Albumin as a Resuscitative Fluid in the Intensive Care Unit

The advent of fluid resuscitation appears to date back to 1832 in response to a cholera outbreak in England.¹  Crystalloid solutions have predominantly been used as initial resuscitative fluids in critically ill patients. Since the first clinical use of a human albumin solution was documented in 1941,²  clinicians and researchers have evaluated the use of albumin and other colloids as compared with crystalloids. Albumin has fallen out of favor for some clinicians because of the lack of clinical benefits over crystalloids in multiple large randomized controlled trials and the cost of albumin compared with alternative fluids.^3–5  With over 35% of patients receiving fluid resuscitation on any given day in the intensive care unit,⁶  understanding the nuances between resuscitative fluids is paramount to caring for the critically ill patient because no ideal fluid exists. The purposes of this article are to review the role of...