***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: To assess the effects of crystalloid and colloid resuscitation on hemodynamic response and on lung water  following thermal injury , 79 patients were assigned r and omly to receive lactated Ringer 's solution or 2.5 % albumin-lactated Ringer 's solution . Crystalloid-treated patients required more fluid for successful resuscitation than did those receiving colloid solutions ( 3.81 vs. 2.98 ml/kg body weight/% body surface burn , p < 0.01 ) . In study phase 1 ( 29 patients ) , cardiac index and myocardial contractility ( ejection fraction ' and mean rate of internal fiber shortening , Vcf ) were determined by echocardiography during the first 48 hours postburn . Cardiac index was lower in the 12-to 24-hour postburn interval in the crystalloid group , but this difference between treatment groups had disappeared by 48 hours postburn . Ejection fractions were normal throughout the entire study , while Vcf was supranormal ( p < 0.01 vs. normals ) and equal in the two resuscitation groups . In study phase 2 ( SO patients ) , extravascular lung water and cardiac index were measured by a st and ard rebreathing technique at least daily for the first postburn week . Lung water remained unchanged in the crystalloid-treated patients ( p > 0.10 ) , but progressively increased in the colloid-treated patients over the seven day study ( p < 0.0001 ) . The measured lung water in each treatment group was significantly different from one another ( p < 0.001 ) . Cardiac index increased progressively and identically in both treatment groups over the study period ( p < 0.01 ) . These data refute the existence of myocardial depression during postburn resuscitation and document hypercontractile left ventricular performance . The addition of colloid to crystalloid resuscitation fluids produces no long lasting benefit on total body blood flow , and promotes accumulation of lung water when edema fluid is being reabsorbed from the burn wound In a prospect i ve r and omized trial of 16 patients undergoing abdominal vascular reconstructive procedures  , changes in plasma volume , serum oncotic pressure ( pis ) , serum albumin and total protein concentration , alveolar to arterial oxygen tension differences ( AaDO2 , FIO2 = 1.0 ) , creatinine clearance , body weight , and fluid and sodium intake were examined . By r and om assignment patients received either an albumin- or a sodium-rich intraoperative fluid regimen .  Pulmonary arteriovenous admixture was significantly less in the albumin group ( n = 7 ) than in the electrolyte group ( n = 9 ) on the first postoperative day . The change in AaDO2 correlated positively with the total sodium intake in the electrolyte group . Despite the larger fluid load and significantly greater gain of body weight , patients in the electrolyte group had a postoperative plasma volume significantly lower than the preoperative value . Postoperative values of albumin concentration , circulating albumin mass and pis were significantly greater in the albumin group in comparison to the electrolyte group . Creatinine clearance values were not different between the two groups . The change in pis correlated significantly with sodium intake and circulating albumin mass . Pulmonary shunting and expansion of the extracellular fluid volume may be minimized without adverse effects on renal function by administration of fluids rich in albumin in preference to sodium OBJECTIVE To determine whether replacement of human albumin will improve a patient 's prognosis . DESIGN A r and omized , double-blind , controlled study in which 25 g of human albumin vs. placebo was administered intravenously daily . SETTING A university-affiliated hospital . PATIENTS Thirty-six patients with hypoalbuminemia ( serum albumin of < 2.5 g/dL ) , receiving total parenteral nutrition . None of the patients had known cancer , cirrhosis , or nephrotic syndrome . INTERVENTIONS Each patient received at least 6 days of therapy ( 6 to 24 days of albumin ; 7 to 32 days of placebo ) . Four subjects were excluded from the study since they received therapy for < 6 days . One patient was excluded from the study after nephrotic syndrome was identified . Albumin metabolic rates for those patients receiving albumin were estimated using the formula : Metabolism of albumin = 25 g/day + ( albumin 1 - albumin 2)(Vd)/days , where albumin 1 and 2 are the serum albumin concentrations ( g/L ) at the beginning and end of the serum sampling intervals , respectively ; Vd is the volume of distribution ( L ) ; and days relates to the number of days of the sampling interval . MEASUREMENTS AND MAIN RESULTS Sixteen patients received albumin ; 15 patients received placebo . One patient receiving placebo and two patients receiving albumin  died within 30 days . One patient who received placebo and three patients who received albumin developed sepsis or bacteremia ; four patients who received placebo and seven patients who received albumin developed pneumonia during the study ( NS ) . The serum albumin increased in all patients receiving intravenous albumin , but one patient received intravenous albumin for only 6 days . The mean serum albumin concentration increased by 1.42 g/dL in the albumin patients , and increased by 0.29 in the placebo patients ( p < .0001 by unpaired t-test ) . Mean initial albumin metabolism was 17.4 g/day ( 0.3 g/kg/day ) . At the end of therapy , albumin metabolism was 20.5 g/day ( 0.36 g/kg/day ) ( paired t-test , p = .4 , NS ) . CONCLUSIONS a ) The administration of intravenous albumin to hypoalbuminemic patients receiving total parenteral nutrition does not improve morbidity or mortality . b ) Albumin metabolic rates , initially related to the catabolic state , are high ; later , these rates are high related to filling of the albumin space and gluconeogenesis . c ) On the basis of the high albumin catabolic rates at the end of the infusion , doses of albumin of < 25 g/day might be sufficient to replace albumin stores The effects of concurrent administration of albumin with total parenteral nutrition were studied in 12 premature newborns ( birth weight 1.26 + /- 0.1 kg [ mean + /- SEM ] and gestational age 30 + /- 0.8 weeks [ mean + /- SEM ] ) compared with a control group of 12 premature newborns ( birth weight 1.17 + /- 0.2 kg and gestational age 29 + /- 0.1 weeks ) who received total parenteral nutrition . All newborns had a plasma albumin level below 3 g/dL and were in cardiorespiratory distress requiring assisted ventilation .  Albumin supplementation of total parenteral nutrition result ed in a sustained increase in serum albumin concentration as well as increased mean arterial blood pressures in the study group . Slow albumin infusion had no observed effect on the severity of respiratory distress . Study group infants regained birth weight earlier than control group infants . These data suggest that the concurrent administration of albumin may be clinical ly beneficial in critically ill newborn infants Patients with colorectal cancer undergoing elective surgery with resection of the tumour and primary anastomosis were r and omly allocated into two groups . 29 patients received a total of 60 - 75 g of albumin postoperatively , 30 patients received no albumin and served as controls . The two groups were comparable with respect to age and sex of the patients and stage of growth of the tumour . The patients who received albumin had a significantly lower preoperative serum albumin concentration . On day 4 after the operation the serum albumin concentrations of the control patients and the patients who received albumin were 20 % and 5 % lower , respectively , than the preoperative value . Eight patients of the albumin group and 5 of the control group developed postoperative complications . There was no significant difference in the postoperative clinical course between the two groups . Preoperative serum albumin levels did not differ between patients who developed postoperative complications and those who had an uneventful postoperative course whether or not they received albumin postoperatively . The present study does not confirm earlier results indicating that serum albumin alone is of prognostic value for the postoperative course following colorectal surgery . Furthermore , the postoperative course is not improved by addition of albumin postoperatively and hence albumin should be given in this situation only when its specific oncotic effect is required Colloid  osmotic pressure ( COP ) was followed postoperatively in 55 r and omized patients . After minor operations and short-term infusion therapy only small changes of the COP could be observed and it was concluded that after such operation COP measurement is unnecessary . After major surgical interventions , however , COP measurement gave valuable hints . It was shown that even in the case of moderate blood loss replaced by crystalloids an abnormally low COP did not occur . The same applied also to preoperative hemodilution . It was unnecessary to substitute the withdrawn blood with a colloid solution . In addition , COP measurement helped to avoid expensive albumin administrations and indicated colloid overload in cases of pulmonary edema Albumin replacement to correct hypoalbuminemia in critically ill patients has been controversial . This study was a prospect i ve , r and omized trial of 25 % albumin administration in 40 hypoalbuminemic ( serum albumin , less than 25 g/L [ 2.5 g/dL ] ) , critically ill patients . The treatment group ( 18 patients ) received 25 % albumin supplementation to achieve and maintain serum albumin levels of 25 g/L ( 2.5 g/dL ) or greater , while the nontreatment group ( 22 patients ) received no concentrated albumin . There was no clinical benefit from albumin therapy when assessing mortality ( 39 % vs 27 % , treatment vs control ) or major complication rate ( 89 % vs 77 % of patients ) . There were also no significant differences in length of hospital stay , intensive care unit stay , ventilator dependence , or tolerance of enteral feeding , despite significant elevations of albumin in the treatment group . The costly use of exogenous albumin as treatment for hypoalbuminemia in this patient population does not appear to be justified The effect of decreased colloid oncotic pressure , as seen in hypoalbuminemia and hypoproteinemia , upon intestinal function has been well delineated in the surgical literature . Patients undergoing abdominal aortic aneurysm resection or aortoiliac or aortofemoral bypass grafts  are almost uniformly hypoalbuminemic postoperatively ; with these two facts in mind , a prospect i ve , r and omized clinical study was undertaken to identify the role of serum albumin concentration on the length of postoperative ileus in this population . The main hypothesis was that patients whose albumin levels dropped below 3.5 gm/dL would have a more prolonged postoperative hospital course as a result of delay in return of bowel function when compared with those patients in whom the low albumin levels were exogenously acutely replenished to > 3.5 gm/dL. Albumin was replaced to a level greater-than or equal to 3.5 g/dL in one group of 37 patients ( AR ) , with a control group of 32 patients ( NR ) not receiving any albumin . Return of bowel function was measured by the postoperative day that flatus was documented , as well as the postoperative day oral intake was resumed . Mean values were determined for each group , and t tests did not reveal a significant difference in postoperative day of flatus ( AR mean = 4.06 days , NR mean = 4.16 days ) or postoperative day of oral intake ( AR mean = 4.0 , NR mean = 3.75 ) . Additional comparisons between the groups involving the number of postoperative days until a regular diet was begun ( AR mean = 6.06 , NR mean = 5.48 ) and length of postoperative hospital stay ( AR mean = 9.16 , NR mean = 8.43 ) failed to reveal significant differences . ( ABSTRACT TRUNCATED AT 250 WORDS The effects on fluid balance , pulmonary tunctions and economics were evaluated in a r and omized comparison of one colloid free and three colloid containing fluid regimens , for 48 hours during and after coronary artery‐bypass ( CAB ) surgery Cardiac output and pulmonary wedge pressure ( PWP ) were used to evaluate the end point of fluid resuscitation in 20 patients suffering from multiple trauma and shock . Eleven patients received crystalloid resuscitation and nine patients received colloid resuscitation . Fifteen of 20 patients had an adequate cardiac output at the termination of resuscitation , but but only six of these patients had a PWP above 10 mm Hg . There was no significant correlation between left ventricular stroke work index and PWP in these patients , either at the completion of resuscitation or during the following three days . Five patients did not achieve adequate cardiac output and four of these patients died , suggesting that cardiac output was the most important criterion for adequate resuscitation . If the goal of fluid resuscitation is to achieve an adequate cardiac output , then PWP was not a reliable guide . Furthermore , using both cardiac output and PWP as a guide to fluid resuscitation of our patients , we found that the type of fluid ( crystalloid or colloid ) for resuscitation did not influence the course of respiratory distress in these patients up to three days following resuscitation Hemodynamic , pulmonary , and renal variables were measured in 24 patients scheduled for major abdominal aortic operations . Control values were obtained before preoperative medications were given . All patients received 5 % dextrose in Lactated Ringer 's solution intraoperatively . Postoperatively , group 1 patients received 5 % dextrose in water plus albumin , group 2 received 5 % dextrose in 0.45 sodium chloride solution , and group 3 received 5 % dextrose in lactated 
    Output:
    
CONCLUSIONS There is no evidence that albumin administration reduces mortality in critically ill patients with hypovolaemia , burns , or hypoalbuminaemia and a strong suggestion that it may increase mortality .