Colloid or crystalloid in the resuscitation of hemorrhagic shock: a controlled clinical trial

The object of this article is to assess the value of human serum albumin (HSA) in the initial resuscitation of hypotensive trauma victims. Thirty-six patients (mean age = 30 years) in shock from trauma who underwent laparotomies were randomly assigned to either Ringer's lactate solution (RL) resuscitation or 4% HSA in RL resuscitation. Both groups received approximately 8L of test fluid and 6U of washed red cells. The only death in the study occurred in a patient assigned to the RL group. Two patients in each group required mechanical ventilation for longer than 24 hours. No differences were noted in a battery of pulmonary function tests performed daily for 5 days. These results demonstrate that HSA is not essential in this clinical setting for safe and effective resuscitation.