Use of albumin in intensive care units in the United kingdom.

OBJECTIVE: To review the use of intravenous albumin solutions in intensive care units in the United Kingdom. METHODS: A postal questionnaire was sent to the clinical directors of all intensive care units in the United Kingdom (n = 292) asking about their use and indications for intravenous albumin solutions. RESULTS: Responses were received from 261 (89.4%) intensive care units (ICUs). The units were classified as general ICUs (n = 198), paediatric ICUs (n = 22) and combined intensive care/coronary care units (ICU/CCUs) (n = 41). Of the 261 units that replied, 181 (69.3%) reported using intravenous albumin, although the indications varied between units particularly in paediatric intensive care units. The alternatives to albumin also varied between the units. The general ICUs favoured hydroxyethyl starch (n = 129, 65.2%) and/or gelatin solutions (n = 87, 43.9%), as did the combined ICU/CCUs (n = 28, 68.3% and/or n = 23, 56.1% respectively). However, of the paediatric ICUs that used an alternative to albumin solutions (n = 21/22), 12 favoured crystalloid solutions (54.5%) and 9 favoured gelatin solutions (40.9%). We also assessed the impact of the recent review by the Cochrane Injuries Group Reviewers on the use of albumin and found that the respondents of 131 units (50.2%) reported that this study influenced their use of intravenous albumin. Of the 80 units that did not use albumin solutions, 33 units reported that they had ceased using intravenous albumin following the review from the Cochrane Injuries Group Reviewers. CONCLUSIONS: Approximately two-thirds of intensive care units in the United kingdom reported using intravenous albumin, although the indications varied between units. In many of these units the use of intravenous albumin had been influenced by the recent review by the Cochrane Injuries Group Reviewers on the use of albumin.