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Lactated Ringer Versus Albumin in Early Sepsis Therapy

Phase 3
Completed
Conditions
Septic Shock
Severe Sepsis
Interventions
Drug: Lactated Ringer
Registration Number
NCT01337934
Lead Sponsor
University of Sao Paulo
Brief Summary

The use of albumin in critical ill patients is a matter of controversy. A large randomized controlled trial reported that albumin was as safe and effective as crystalloid solution for fluid replacement in intensive care unit, although the last one was less expensive. In Surviving Sepsis Campaign International Guidelines there are no preference for crystalloids over colloids. But recently, a retrospective analysis of patients with severe sepsis from SAFE study reported that the use of albumin in these patients would be superior, regarding reduction of mortality. The aim of this study is determine whether the use of albumin improve clinical outcomes in patients with severe sepsis or septic shock.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
360
Inclusion Criteria
  • Age equal or higher than 18 years-old
  • Severe sepsis or septic shock into 6 hours of evolution
  • Written informed consent
Exclusion Criteria
  • Shock from other causes
  • Adverse reactions to human albumin
  • Previous fluid resuscitation during current disease
  • Previous use of albumin in the last 72 hours
  • Religion objection
  • Enrollment in another study
  • Traumatic brain injury
  • Hepatic cirrhosis
  • End stage renal disease
  • Plasmapheresis
  • End of life patients

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
AlbuminAlbuminPatients randomized for Albumin group will receive 500 ml of 4% Albumin solution in early phase of sepsis (less than six hour from sepsis onset) if mean arterial pressure was under 65mmHg or blood lactate concentration higher than 4 mmol/L or base excess under - 4mmol/L until the target of central venous pressure of 8 mmHg or higher or recovery of hypotension.
Lactated RingerLactated RingerPatients randomized for this group will receive 500 ml of lactated Ringer solution in early phase of sepsis or septic shock (less than six hour from sepsis onset) if mean arterial pressure was under 65mmHg, or blood lactate concentration higher than 4 mmol/L or base excess under - 4mmol/L until the target of central venous pressure of 8 mmHg or higher or recovery of hypotension.
Primary Outcome Measures
NameTimeMethod
Mortality in 7 days for any causeday 7
Secondary Outcome Measures
NameTimeMethod
hospital length of stayday 28
ICU length of stayday 28
days free of vasopressorday 28
Mortality in 28-days28 days after randomization
Evaluation of sequential organ failure assessment (SOFA) scorefrom day 1 until day 7 of care in ICU
ventilator-free daysday 28
Needing of renal replacement therapyday 28

Trial Locations

Locations (1)

Cancer Institute of Sao Paulo, School of Medicine, University of Sao Paulo

🇧🇷

Sao Paulo, Sao Paulo/SP, Brazil

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