Muristek
Use of Albumin Solution in Patients Undergoing Cardiac Surgery With Cardiopulmonary Bypass—Reply
In Reply We agree with Dr Zhou and colleagues that the low-risk patient profile and intervention design of our study reduced the generalizability of the results, as stated in the limitations section of the article. Because the primary outcome measure was the composite of 9 major perioperative and postoperative adverse events, we needed to exclude patients already preoperatively fulfilling any of the primary outcome criteria. Otherwise, the primary outcome measure would not have been comparable among all study patients, complicating interpretation of the primary study result. Because bleeding was a major component of the primary outcome, we decided to exclude patients receiving adenosine diphosphate receptor inhibitors within 2 preoperative days. This likely reduced the number of patients with unstable coronary syndrome. We agree that more unstable patients might have had more hemodynamic benefit from administration of colloids vs crystalloids. However, several results indicated increased bleeding in the albumin group. Although these results are exploratory due to lacking power calculations, they corroborate the results of a previous smaller trial in cardiac surgery.
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