Original Article

Neurocritical Care

, Volume 20, Issue 2, pp 277-286

Human Albumin Administration in Subarachnoid Hemorrhage: Results of an International Survey

  • Jose I. SuarezAffiliated withDivision of Vascular Neurology and Neurocritical Care, Department of Neurology, Baylor College of Medicine Email author 
  • , Renee H. MartinAffiliated withDivision of Biostatistics and Epidemiology, Medical University of South Carolina
  • , Eusebia CalvilloAffiliated withDivision of Vascular Neurology and Neurocritical Care, Department of Neurology, Baylor College of Medicine
  • , David ZygunAffiliated withDivision of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta
  • , Oliver FlowerAffiliated withDivision of Intensive Care, North Shore Hospital, University of Sydney
  • , George K. WongAffiliated withDepartment of Surgery, Faculty of Medicine, Chinese University of Hong Kong
  • , Eric M. BershadAffiliated withDivision of Vascular Neurology and Neurocritical Care, Department of Neurology, Baylor College of Medicine
  • , Chethan P. Venkatasubba RaoAffiliated withDivision of Vascular Neurology and Neurocritical Care, Department of Neurology, Baylor College of Medicine
  • , Alexandros GeorgiadisAffiliated withDivision of Vascular Neurology and Neurocritical Care, Department of Neurology, Baylor College of Medicine
    • , Draga JichiciAffiliated withDepartment of Neurology and Critical Care Medicine, McMaster University
    • , Peter D. LerouxAffiliated withDepartment of Neurosurgery, Thomas Jefferson University

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Abstract

Background

Subarachnoid hemorrhage (SAH) is a devastating disease. Nimodipine is the only medical treatment shown to improve outcome of SAH patients. Human albumin (ALB) may exert neuroprotection in SAH. However, current usage of ALB in SAH is not known. We conducted an international survey of clinicians involved in the care of SAH patients to determine current practice of ALB administration in SAH.

Methods

We constructed a 27-question survey. Our sampling frame consisted of neurointensivists, general intensivists, neurocritical care nurses, critical care pharmacists, and neurosurgeons. The survey was available from 11/15/2012 to 12/15/2012. We performed mostly descriptive statistical analysis.

Results

We obtained 362 responses from a diverse range of world regions. Most respondents were intensivist physicians (88 %), who worked in academic institutions (73.5 %) with a bed capacity >500 (64.1 %) and an established institutional management protocol for SAH patients (70.2 %). Most respondents (83.5 %) indicated that their institutions do not incorporate ALB in their protocol, but half of them (45.9 %) indicated using ALB outside it. ALB administration is influenced by several factors: geographic variation (more common among US respondents); institutions with a dedicated neuroICU; and availability of SAH management protocol. Most respondents (75 %) indicated that a clinical trial to test the efficacy of ALB in SAH is needed.

Conclusions

In this survey we found that ALB administration in SAH patients is common and influenced by several factors. Majority of respondents support a randomized clinical trial to determine the safety and efficacy of ALB administration in SAH patients.

Keywords

Human albumin Subarachnoid hemorrhage Neuroprotection Outcomes Delayed cerebral ischemia