Crystalloid versus Albumin in the Resuscitation of Emergency Department Patients with Septic Shock

Individuals who present to the Emergency Department with severe infections are treated with fluids in the vein to maintain optimal blood volume, keep the heart working properly, and keep tissues well oxygenated. There are a number of fluids that Emergency Physicians can provide to patients including saline and 4% albumin. Further work is required to determine which of these fluids is most effective in improving the outcome of patients with severe infection. This project aims to determine whether 4% albumin solution is superior to crystalloid solutions for fluid resuscitation of patients presenting to the Emergency Department (ED) with septic shock. A randomised controlled trial is proposed, in which 100 patients will be enrolled over 2 years, each assigned to receive either 4% albumin or crystalloid fluids for the first six hours of resuscitation in the ED. All other aspects of care will be common to both groups and according to evidence-based guidelines. A variety of outcomes will be measured, including organ dysfunction scores, inflammatory markers and measures of circulation.