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Efficacy and safety of albumin for the treatment of hepatic encephalopathy: an updated systematic review and meta-analysis of randomized controlled trials.
Murtaza, Farhan; Mathew, Midhun; Fagbamila, Oluwaseun; Subramani, Sachin; Nimal, Simran; Nyshita, Veeramachaneni Naga; Priya, Vishnu; Sany, Abu Talha; Kumar, Yamanth; Cicani, Laura; Ehsan, Muhammad; Kandel, Kamal.
Afiliación
  • Murtaza F; Department of Medicine, Allama Iqbal Medical College.
  • Mathew M; Department of Medicine, Pennsylvania Hospital, Philadelphia, PA.
  • Fagbamila O; Saint Elizabeth Health Care Center, Mississauga, ON, Canada.
  • Subramani S; Department of Medicine, ESIC Medical College and Hospital, Gulbarga.
  • Nimal S; Department of Medicine, BJ Medical College, Pune.
  • Nyshita VN; Department of Medicine, Andhra Medical College, Visakhapatnam.
  • Priya V; Department of Medicine, Government Kilpauk Medical College, Chennai, India.
  • Sany AT; Department of Medicine, Brahmanbaria Medical College & Hospital, Brahmanbaria, Bangladesh.
  • Kumar Y; Department of Medicine, Government Kilpauk Medical College, Chennai, India.
  • Cicani L; Department of Medicine, International University of Health Sciences, Las Vegas, NV.
  • Ehsan M; Department of Medicine, King Edward Medical University, Lahore, Pakistan.
  • Kandel K; Kathmandu University, Dhulikhel, Nepal.
Ann Med Surg (Lond) ; 86(6): 3416-3422, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38846811
ABSTRACT

Background:

Albumin acts as a scavenger of reactive oxygen species and an inhibitor of inflammatory processes that underlie hepatic encephalopathy (HE). However, the role of albumin in hepatic encephalopathy is not well-established. The authors performed this meta-analysis to evaluate the efficacy and safety of albumin in the management of hepatic encephalopathy.

Methods:

The authors carried out an extensive search across multiple databases, including MEDLINE (via PubMed), Embase, CENTRAL, and various trial registries, to identify randomized controlled trials (RCTs) evaluating the impact of albumin administration in HE. The authors used a random-effects model for analyses and presented dichotomous outcomes and continuous outcomes as relative risk and mean difference, along with corresponding 95% CIs, respectively. Heterogeneity was assessed using both the I2 index and χ2 test.

Results:

Our meta-analysis included 4 RCTs involving 306 patients. Our primary outcomes, mortality, and persistence of HE were reported by all four studies. Albumin was found to significantly decrease mortality in patients with HE [risk ratio (RR) 0.52, 95% CI 0.32-0.83; I2 =0%]. Persistence of HE was found to be comparable between the two groups (RR 0.83, 95% CI 0.68-1.00; I2 =24%). There was no significant difference between the albumin and control groups regarding length of hospital stay (MD -1.55, 95% CI -3.5 to 0.14; I2 =41%), adverse events (RR 1.00, 95% CI 0.87-1.16; I2 =0%), and severe adverse events (RR 0.89, 95% CI 0.59-1.35).

Conclusion:

Albumin administration in patients with hepatic encephalopathy decreases mortality but does not significantly impact the persistence of HE. Further high-quality, large-scale randomized controlled trials are needed to provide conclusive evidence.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ann Med Surg (Lond) Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ann Med Surg (Lond) Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido