The SAFE study comparing albumin versus saline for fluid resuscitation showed that 4% albumin was associated with harm in which specific patient population?
- A Patients with septic shock
- B Patients with traumatic brain injury ✓
- C Patients with hypoalbuminaemia <25 g/L
- D Patients post-major hepatic surgery
Correct answer: B. Patients with traumatic brain injury
Explanation
The SAFE study (2004) found albumin and saline equivalent for ICU resuscitation overall, but a pre-specified subgroup analysis showed that albumin was associated with significantly higher 28-day mortality in patients with traumatic brain injury (RR 1.63). The mechanism is thought to involve albumin crossing a disrupted blood-brain barrier, exacerbating oedema. Saline is therefore preferred in TBI. In severe sepsis, albumin may be beneficial.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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