Get access

Albumin infusion for low serum albumin in preterm newborn infants

  • Review
  • Intervention


  • Luke A Jardine,

    Corresponding author
    1. Mater Mother's Hospital, Brisbane, Queensland, Australia
    Search for more papers by this author
  • Sue Jenkins-Marsh,

    1. Office of Health and Medical Research, Centre for Health Care Improvement, Queensland Health, Research Ethics and Governance Unit, Brisbane, Queensland, Australia
    Search for more papers by this author
  • Mark W Davies

    1. Department of Paediatrics & Child Health, The University of Queensland, Grantley Stable Neonatal Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
    Search for more papers by this author



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.


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.




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。




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。






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。


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。



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



Plain language summary

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.

Get access to the full text of this article