Evidence map›Paper›PMID 42410446›Full record

SynthesisCritical care (London, England)2026

Mortality effect of albumin fluid resuscitation in adults with septic shock: a systematic review and dual frequentist-bayesian meta-analysis of randomised trials.

Henrique Mendes, Henry Kinkei Wen, Harry de Souza, Yuanyuan Peng, Kush Deshpande, Siebe G Blok, Pieter R Tuinman, Ary Serpa Neto, Marcus J Schultz, Manu L N G Malbrain and 2 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Henrique MendesSt George Hospital, Sydney, Australia. henrique.gomesmendes@health.nsw.gov.au.ORCID http://orcid.org/0000-0002-8372-9176
Henry Kinkei WenSt George Hospital, Sydney, Australia.
Harry de SouzaSt George Hospital, Sydney, Australia.
Yuanyuan PengSt George Hospital, Sydney, Australia.
Kush DeshpandeSt George Hospital, Sydney, Australia.
Siebe G BlokDepartment of Intensive Care Medicine, Amsterdam UMC, Amsterdam, The Netherlands.
Pieter R TuinmanDepartment of Intensive Care Medicine, Amsterdam UMC, Amsterdam, The Netherlands.
Ary Serpa NetoAustralian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Marcus J SchultzMedical University Wien, Vienna, Austria.
Manu L N G MalbrainFirst Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Jaczewskiego Lublin, Poland.
Giacomo GrasselliDepartment of Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Frank M P van HarenSt George Hospital, Sydney, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the effect of albumin-based fluid resuscitation on mortality in adults with septic shock.

designSystematic review and dual frequentist-Bayesian meta-analysis of randomised clinical trials (RCTs), following PRISMA guidelines and preregistered protocol (CRD420261325998). DATA SOURCES: PubMed, Embase, CENTRAL, and Scopus were searched from inception to February 2026.

methodsEligible RCTs comparing albumin-based resuscitation strategies versus crystalloid-based resuscitation in adults with septic shock were included. The primary outcome was all-cause mortality at the longest available follow-up (up to 90 days). The analysis utilised random-effects models, subgroup analyses, and Bayesian methods.

resultsSeven trials (n = 3273) were included. Three trials primarily recruited septic shock patients, while data from the remaining were derived from subgroups or extracted strata. At the longest available follow-up, albumin-based fluid resuscitation was associated with a statistically significant 10% reduction in the relative risk of all-cause mortality (RR 0.90, 95% CI 0.83-0.99; p = 0.02; I² = 0%). Bayesian analysis under the primary weakly informative prior yielded a posterior probability of mortality reduction of 94.7% (P[RR < 1.0]). Pre-specified subgroup analyses by albumin formulation, dosing strategy, and trial-level baseline serum albumin did not show evidence of effect modification.

conclusionIn adults with septic shock, albumin-based resuscitation strategies are associated with a statistically significant reduction in mortality at the longest available follow-up, with a directionally concordant Bayesian estimate. A mortality benefit is therefore plausible, but the supporting evidence is indirect and imprecise (GRADE: low certainty). Adequately powered trials specifically addressing albumin fluid resuscitation in septic shock are warranted.

Indexed as

AlbuminsFluid TherapyResuscitationShock, SepticBayes TheoremCrystalloid SolutionsHumansRandomized Controlled Trials as TopicAlbuminsCrystalloid SolutionsAlbuminBayesianCrystalloidFluid therapyHuman serum albuminHyperoncoticIso-oncoticMeta-analysisMortalityResuscitationSeptic shock

Identifiers

PMID42410446
PMCPMC13379965

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.