Authors' recommendations: In many indications, the evidence was mixed for the clinical efficacy of albumin and synthetic plasma volume expanders, particularly HES, with respect to hemodynamics and other biochemical end points. It is therefore difficult to draw firm conclusions about their clinical benefits. In term of mortality, the effect of albumin was not different compared to synthetic plasma volume expanders. The use of high molecular weight high molar substitution HES in septic patients was associated with increased risk of developing kidney failure or need for dialysis compared to albumin. The British Guidelines recommend that those HES should be avoided in patients with severe sepsis. Results of recent randomized controlled studies suggest that new generations of HES (130/0.4 or 130/0.42) might be better than or as effective as albumin, and could be used as alternative for hypovolaemic treatment in patients undergoing surgery. Cost-minimization analysis revealed that albumin appears is superior to polygeline in preventing complications in patients with cirrhosis and ascites. Cost-effectiveness data of albumin versus HES or dextrans were not found. Although numerous studies were found on synthetic plasma volume expanders, particularly HES and albumin, the varied results may be a consideration for decision-making.

Project Status: Completed

URL for project: http://www.cadth.ca/media/pdf/l0178_plasma_protein_products_htis-2.pdf

Year Published: 2010

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Canadian Agency for Drugs and Technologies in Health

Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;

Contact Name: requests@cadth.ca

Contact Email: requests@cadth.ca

Copyright: Canadian Agency for Drugs and Technologies in Health (CADTH)