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20% Human Albumin Solution Fluid Bolus Administration Therapy in Patients After Cardiac Surgery (the HAS FLAIR Study)

Wigmore G et al
30 January, 2020  

The open-label, hypothesis-generating HAS FLAIR study was conducted to determine whether the administration of colloid albumin at a concentration of 20% could result in improved haemodynamics after heart surgery compared to a crystalloid fluid.

A total of 100 post-operative patients at the intensive care unit were included in the analysis; 50 patients (control group) received crystalloid fluid-based bolus therapy (that is, Hartmann’s solution, 0.9% saline) to correct hypotension or hypovolaemia, or to optimise a low cardiac index, and 50 (intervention group) received up to two boluses of 20% albumin, followed by crystalloid fluid, if warranted.

After 24 hours, patients who received albumin showed a lower net positive fluid balance of almost 1 litre. The number of episodes of fluid bolus administration as well as the total volume of resuscitation fluid were also lower in the intervention vs. the control group. Cardiac output, mean arterial pressure, and central venous pressure did not change after the first fluid bolus.

Although no significant differences in mortality were observed, hospitalisation time and duration of mechanical ventilation were shorter for the group receiving albumin.

Albumin therapy was also associated with a lower cumulative dose of norepinephrine and shorter time to discontinuation of this vasopressor.