Crystalloid vs colloid
- no clear advantage of either
SAFE trial (NEJM, 2004)
- confirmed that 4% albumin was ‘safe’ when compared to normal saline in the critically unwell requiring fluid resuscitation.
- post hoc analysis showed that patients with TBI and major trauma had worse outcomes with albumin and patients with septic shock tended to better with albumin.
- ARDS patients do better with albumin.
NORMAL SALINE VERSUS 4% ALBUMIN