Intervention Review

Albumin infusion for low serum albumin in preterm newborn infants

  1. Luke A Jardine1,*,
  2. Sue Jenkins-Marsh2,
  3. Mark W Davies3

Editorial Group: Cochrane Neonatal Group

Published Online: 19 JUL 2004

Assessed as up-to-date: 2 AUG 2009

DOI: 10.1002/14651858.CD004208.pub2


How to Cite

Jardine LA, Jenkins-Marsh S, Davies MW. Albumin infusion for low serum albumin in preterm newborn infants. Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD004208. DOI: 10.1002/14651858.CD004208.pub2.

Author Information

  1. 1

    Mater Mother's Hospital, Brisbane, Queensland, Australia

  2. 2

    Office of Health and Medical Research, Centre for Health Care Improvement, Queensland Health, Research Ethics and Governance Unit, Brisbane, Queensland, Australia

  3. 3

    Department of Paediatrics & Child Health, The University of Queensland, Grantley Stable Neonatal Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia

*Luke A Jardine, Mater Mother's Hospital, Raymond Terrace, Brisbane, Queensland, 4101, Australia. Luke.Jardine@mater.org.au.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 19 JUL 2004

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Intravenous albumin infusion is used to treat hypoalbuminaemia in critically ill infants. Hypoalbuminaemia occurs in a number of clinical situations including prematurity, respiratory distress syndrome (RDS), chronic lung disease (CLD), necrotising enterocolitis (NEC), intracranial haemorrhage, hydrops fetalis and oedema. Fluid overload is a potential side effect of albumin administration. Albumin is a blood product and therefore carries the potential risk of infection and adverse reactions. Albumin is also a scarce and expensive resource.

Objectives

To assess the effect of albumin infusions on morbidity, mortality, and other significant side effects in preterm neonates with low serum albumin.

Search methods

Searches were made of MEDLINE from 1966 to July 2009, CINAHL from 1982 to July 2009 and the current Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2009). Previous reviews (including cross references) and abstracts were also searched.

Selection criteria

All randomised and quasi randomised controlled trials in which individual patients were allocated to albumin infusion versus control were included. Cross-over studies were excluded. Participants were preterm infants who had hypoalbuminaemia. Types of interventions included albumin infusion versus placebo (e.g. crystalloid) or no treatment.

Data collection and analysis

The reviewers worked independently to search for trials for inclusion and to assess methodological quality. Studies were assessed using the following key criteria: blinding of randomisation, blinding of intervention, completeness of follow-up and blinding of outcome measurement.

Main results

Only two small studies were found for inclusion in this review and only one reported clinically relevant outcomes. This study found no significant differences for the primary outcome measure of death (relative risk 1.5, 95% confidence interval 0.3 - 7.43) or secondary outcome measures of intraventricular haemorrhage, patent ductus arteriosus, necrotising enterocolitis, bronchopulmonary dysplasia, duration of mechanical ventilation and duration of oxygen therapy.

Authors' conclusions

There is a lack of evidence from randomised trials to determine whether the routine use of albumin infusion in preterm neonates with low serum albumin reduces mortality or morbidity and no evidence to assess whether albumin infusion is associated with significant side effects. There is a need for good quality, double-blind randomised controlled trials to assess the safety and efficacy of albumin infusions in preterm neonates with low serum albumin.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Albumin infusion for low serum albumin in preterm newborn infants

There is a lack of evidence from randomised trials to either support or refute the routine use of albumin infusion for premature babies with a low albumin level. Albumin is a protein that is normally present in the blood. In premature infants, the albumin level in the blood can be low. Albumin is often given to premature babies with a low albumin level. Only two small randomised controlled trials have studied the use of albumin in sick premature babies, and the trials are not big enough or good enough to decide whether giving albumin helps babies in the short or long-term. Therefore, the question of whether giving albumin does any good and is safe cannot be answered.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

低血清白蛋白早產兒使用白蛋白輸注治療

靜脈輸注白蛋白是用來治療低血清白蛋白病危嬰兒。 低血清白蛋白發生在一些臨床情況,包括早產兒,呼吸窘迫綜合症候群(RDS),慢性肺部疾病(CLD),壞死性小腸結腸炎(NEC),顱內出血,胎兒水腫和水腫。體液過多是使用白蛋白一個潛在的副作用。白蛋白是血液製品,因此攜帶的潛在危險性包括感染和不良反應。白蛋白也同時是一種稀缺和昂貴的資源。

目標

為了評估低血清白蛋白早產兒輸注白蛋白對發病率,死亡率的效果,以及其他明顯的副作用.

搜尋策略

搜索了以下資料庫: MEDLINE從 1966年至2009年7月, CINAHL資料從 1982年至2009年7月, 目前 Cochrane中心註冊的對照試驗(CENTRAL,Cochrane Library,第2期,2009年)。之前的review(包括交叉引用)和摘要也同時有搜索。

選擇標準

所有的隨機和半隨機對照試驗中,只要分配個別患者是輸注白蛋白或控制組都被包括在內。交叉研究被排除在外。參與者是低血清白蛋白早產兒。給予治療包括白蛋白輸注與安慰劑(如晶體溶液)或無治療。

資料收集與分析

審閱者是獨立工作,以搜索符合的試驗和合乎方法學品質的研究。研究使用以下主要標準進行評估:隨機化的blinding,介入治療的blinding,後續追蹤的完整性和測量結果的blinding。

主要結論

只有兩個小型研究發現可列入本次的review並且臨床上只有一個研究報告了相關的臨床結果。本研究發現,兩組再下列結果沒有顯著差異: primary outcome死亡數(相對危險 1.5,95%信賴區間 0.3  7.43)或secondary outcome 腦室內出血,動脈導管未閉,壞死性小腸結腸炎,支氣管肺發育不良,使用呼吸器的時間和氣氧治療的時間。

作者結論

從隨機試驗中缺乏證據以確定是否常規使用白蛋白輸注對低血清白蛋白早產兒,可以降低發病率和死亡率. 並且沒有證據,可以評估是否白蛋白輸注會有明顯的副作用。低血清白蛋白早產兒使用白蛋白輸注治療還需要有良好品質,隨機雙盲的對照試驗,以評估安全性和有效性。

翻譯人

本摘要由臺中榮民總醫院薛榮華翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

低血清白蛋白早產兒使用白蛋白輸注治療:沒有隨機試驗的證據來支持或反駁的常規使用白蛋白輸注治療低血清白蛋白早產兒的功效。白蛋白是一種蛋白質,通常存在於血液中。對早產兒來說,血液中的白蛋白濃度可能較低。低血清白蛋白早產兒常會給予白蛋白補充。只有兩個小型隨機對照試驗研究給予患病的早產兒使用白蛋白,但這個試驗是不夠大或不夠好,來足以決定是否給予白蛋白可短期或長期有助於嬰兒。因此,是否給予白蛋白有任何好處,或安全性的問題是無法回答的。