array:23 [
  "pii" => "S2173572714000563"
  "issn" => "21735727"
  "doi" => "10.1016/j.medine.2013.08.003"
  "estado" => "S300"
  "fechaPublicacion" => "2014-10-01"
  "aid" => "625"
  "copyright" => "Elsevier España, S.L.U. and SEMICYUC"
  "copyrightAnyo" => "2013"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Med Intensiva. 2014;38:403-12"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 3040
    "formatos" => array:3 [
      "EPUB" => 180
      "HTML" => 2116
      "PDF" => 744
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0210569113001861"
      "issn" => "02105691"
      "doi" => "10.1016/j.medin.2013.08.005"
      "estado" => "S300"
      "fechaPublicacion" => "2014-10-01"
      "aid" => "625"
      "copyright" => "Elsevier España, S.L.U. and SEMICYUC"
      "documento" => "article"
      "crossmark" => 0
      "subdocumento" => "fla"
      "cita" => "Med Intensiva. 2014;38:403-12"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 3851
        "formatos" => array:3 [
          "EPUB" => 152
          "HTML" => 2829
          "PDF" => 870
        ]
      ]
      "es" => array:12 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
        "titulo" => "Resultados de una encuesta sobre la pr&#225;ctica cl&#237;nica habitual en el empleo de alb&#250;mina en UCI"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "403"
            "paginaFinal" => "412"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Results of a survey on albumin use in clinical practice in intensive care units"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "M&#46;B&#46; Est&#233;banez-Montiel, M&#46; Quintana-D&#237;az, A&#46; Garc&#237;a de Lorenzo y Mateos, R&#46; Blancas Gomez-Casero, J&#46; Acosta-Escribano, P&#46; Marcos-Neira"
            "autores" => array:7 [
              0 => array:2 [
                "nombre" => "M&#46;B&#46;"
                "apellidos" => "Est&#233;banez-Montiel"
              ]
              1 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Quintana-D&#237;az"
              ]
              2 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Garc&#237;a de Lorenzo y Mateos"
              ]
              3 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Blancas Gomez-Casero"
              ]
              4 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Acosta-Escribano"
              ]
              5 => array:2 [
                "nombre" => "P&#46;"
                "apellidos" => "Marcos-Neira"
              ]
              6 => array:1 [
                "colaborador" => "grupos de Trabajo de Transfusiones y Hemoderivados&#44; y de Metabolismo y Nutrici&#243;n de la Sociedad Espa&#241;ola de Medicina Intensiva y Unidades Coronarias &#40;SEMICYUC&#41;"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173572714000563"
          "doi" => "10.1016/j.medine.2013.08.003"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572714000563?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569113001861?idApp=WMIE"
      "url" => "/02105691/0000003800000007/v1_201409200306/S0210569113001861/v1_201409200306/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2173572714000551"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2013.07.007"
    "estado" => "S300"
    "fechaPublicacion" => "2014-10-01"
    "aid" => "610"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Med Intensiva. 2014;38:430-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2633
      "formatos" => array:3 [
        "EPUB" => 164
        "HTML" => 1740
        "PDF" => 729
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
      "titulo" => "Morbimortality associated to acute kidney injury in patients admitted to pediatric intensive care units"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "430"
          "paginaFinal" => "437"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Morbimortalidad asociada al da&#241;o renal agudo en pacientes ingresados en unidades de cuidados intensivos pedi&#225;tricos"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46;C&#46; G&#243;mez Polo, A&#46;J&#46; Alcaraz Romero, M&#46;A&#46; Gil-Ru&#237;z Gil-Esparza, J&#46; L&#243;pez-Herce Cid, M&#46; Garc&#237;a San Prudencio, S&#46;N&#46; Fern&#225;ndez Lafever, &#193;&#46; Carrillo &#193;lvarez"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "J&#46;C&#46;"
              "apellidos" => "G&#243;mez Polo"
            ]
            1 => array:2 [
              "nombre" => "A&#46;J&#46;"
              "apellidos" => "Alcaraz Romero"
            ]
            2 => array:2 [
              "nombre" => "M&#46;A&#46;"
              "apellidos" => "Gil-Ru&#237;z Gil-Esparza"
            ]
            3 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "L&#243;pez-Herce Cid"
            ]
            4 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Garc&#237;a San Prudencio"
            ]
            5 => array:2 [
              "nombre" => "S&#46;N&#46;"
              "apellidos" => "Fern&#225;ndez Lafever"
            ]
            6 => array:2 [
              "nombre" => "&#193;&#46;"
              "apellidos" => "Carrillo &#193;lvarez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0210569113001575"
        "doi" => "10.1016/j.medin.2013.07.002"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569113001575?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572714000551?idApp=WMIE"
    "url" => "/21735727/0000003800000007/v1_201410030040/S2173572714000551/v1_201410030040/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
    "titulo" => "Results of a survey on albumin use in clinical practice in intensive care units"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "403"
        "paginaFinal" => "412"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "M&#46;B&#46; Est&#233;banez-Montiel, M&#46; Quintana-D&#237;az, A&#46; Garc&#237;a de Lorenzo y Mateos, R&#46; Blancas Gomez-Casero, J&#46; Acosta-Escribano, P&#46; Marcos-Neira"
        "autores" => array:7 [
          0 => array:4 [
            "nombre" => "M&#46;B&#46;"
            "apellidos" => "Est&#233;banez-Montiel"
            "email" => array:1 [
              0 => "belenestebanez&#64;yahoo&#46;es"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Quintana-D&#237;az"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Garc&#237;a de Lorenzo y Mateos"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "R&#46;"
            "apellidos" => "Blancas Gomez-Casero"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Acosta-Escribano"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "P&#46;"
            "apellidos" => "Marcos-Neira"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          6 => array:1 [
            "colaborador" => "Transfusions and Blood Products and Metabolism and Nutrition work groups of the Spanish Society of Intensive Care and Coronary Units &#40;Sociedad Espa&#241;ola de Medicina Intensiva y Unidades Coronarias&#44; SEMICYUC&#41;"
          ]
        ]
        "afiliaciones" => array:4 [
          0 => array:3 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Hospital Universitario del Tajo&#44; Aranjuez&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Hospital Universitario La Paz&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Hospital General Universitario de Alicante&#44; Alicante&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Hospital Universitari Germans Trias i Pujol&#44; Badalona&#44; Barcelona&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Resultados de una encuesta sobre la pr&#225;ctica cl&#237;nica habitual en el empleo de alb&#250;mina en UCI"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Human albumin solutions are obtained from healthy donor plasma after pasteurization at 60<span class="elsevierStyleHsp" style=""></span>&#176;<span class="elsevierStyleSmallCaps">C</span> for 10<span class="elsevierStyleHsp" style=""></span>h&#44; and are used in a broad range of clinical and surgical illnesses&#44; though only some of their indications are authorized&#46; In other cases&#44; the use of albumin solutions must be decided on an individualized basis&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">1&#8211;14</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Although many studies have examined the effects of albumin solutions upon mortality in critical patients&#44; the conclusions have been contradictory<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">1</span></a>&#46; A metaanalysis carried out in 1998 with 30 randomized studies&#44; and two Cochrane reviews&#44;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a> suggested the use of albumin to be associated to increased mortality among critical patients&#46; Posteriorly&#44; another metaanalysis published in the year 2001&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> as well as more recent studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#8211;11</span></a> have failed to confirm such an increase in mortality&#44; except in patients with severe traumatic brain injury &#40;TBI&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> Furthermore&#44; the antioxidant actions of albumin and its effects upon maintenance of the plasma redox state must be taken into account for the adequate designing of future clinical studies&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Albumin solutions are more expensive than other colloids and crystalloids&#46; In addition&#44; although such solutions are usually well tolerated&#44; they are not without risks&#46; In effect&#44; albumin solutions can cause allergic reactions&#44; and very rapid infusion can induce sudden hypotension and&#44; in some cases&#44; heart failure&#8211;particularly when used at high concentrations&#46; Moreover&#44; although albumin solutions are blood products that are considered to be safe in terms of the transmission of infections&#44; there are doubts regarding the possibility of prion transmission through such solutions&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The limited availability of albumin solutions&#44; the risk of adverse effects&#44; and their high cost mean that such solutions must be used only in situations where they are known to be effective&#46; However&#44; the level of evidence on which the recommendations are based is limited&#44; and this is probably reflected in daily clinical practice by a broad range of interventions in which such solutions are used among critical care professionals&#46; With the purpose of assessing the clinical practice in Intensive Care Units &#40;ICUs&#41;&#44; the Transfusions and Blood Products and Metabolism and Nutrition work groups of the Spanish Society of Intensive Care and Coronary Units &#40;<span class="elsevierStyleItalic">Sociedad Espa&#241;ola de Medicina Intensiva y Unidades Coronarias</span>&#44; SEMICYUC&#41; have conducted a survey to evaluate the knowledge and behaviors referred to the use of albumin solutions in ICUs&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Patients and methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">A survey was developed on the use of albumin solutions in critical patients&#46; The Transfusions and Blood Products and Metabolism and Nutrition work groups of the SEMICYUC designed the questionnaire in 2012&#44; and invited Spanish and South American ICUs belonging to both public and private centers to participate via e-mail&#46; The professionals who received the questionnaire were personal contacts of the authors&#44; no preference being assigned to members of the work groups of the SEMICYUC&#46; Within each ICU&#44; only a critical care professional answered the questionnaire&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Fifty-seven ICUs were invited&#44; and all agreed to answer the questionnaire &#40;<a class="elsevierStyleCrossRef" href="#sec0080">Appendix A</a>&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The submitted questionnaire and results obtained are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; The questionnaire consisted of 35 questions&#44; most with multiple and closed answers&#44; and some with open answers&#46; The questions were grouped into different sections covering data referred to the responders and their work centers&#44; albumin use in different disease conditions&#59; and aspects referred to clinical practice&#47;evidence&#46; The aim of the questionnaire was to record the following aspects&#58; general characteristics of the ICU and of the professionals &#40;specialty&#44; years of experience&#44; and work setting&#58; type of hospital center&#44; number of hospital and ICU beds&#44; and annual admissions to the ICU&#41;&#44; usual clinical practice referred to the use of albumin solutions in different disease conditions &#40;nutritional-metabolic&#44; hypovolemia&#44; septic shock&#47;sepsis&#44; and hepatorenal disorders&#41;&#44; degree of knowledge of the available scientific evidence&#44; type of albumin solutions used&#44; and cost&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">The survey was carried out before the publication of the latest update on the Surviving Sepsis Campaign&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The data are expressed as frequencies and percentages in the case of qualitative variables&#44; and as means and standard deviations in the case of quantitative variables&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall">A total of 57 questionnaires from 54 Spanish ICUs and three South American ICUs &#40;Brazil&#44; Chile and Venezuela&#41; were analyzed&#46; All the invited ICUs answered the questionnaire&#46; In turn&#44; all the items of the questionnaire were answered&#44; except three questionnaires that failed to answer the section referred to clinical practice&#47;evidence&#44; and one questionnaire that failed to answer the sections referred to hypovolemia and sepsis&#47;septic shock&#46;</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Data referred to the professional</span><p id="par0055" class="elsevierStylePara elsevierViewall">The first part of the questionnaire explored data referred to the professionals and their working institutions&#46; Most of those interviewed were intensivists &#40;96&#46;5&#37;&#41; and mostly specialists &#40;96&#46;5&#37;&#44; of which 21&#46;1&#37; were Section Chiefs or Heads of Department&#41;&#44; with an average of 15 years of experience&#46; Only two residents in Intensive Care Medicine participated in the study&#46; In 98&#46;2&#37; of the hospital centers&#44; the intensivists were in charge of critical patient care&#46;</p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Data referred to the hospital center</span><p id="par0060" class="elsevierStylePara elsevierViewall">Most of the participating hospitals were secondary &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>23&#59; 40&#46;4&#37;&#41; or tertiary centers &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>26&#44; 45&#46;6&#37;&#41;&#44; and almost all &#40;91&#46;2&#37;&#41; registered more than 300 ICU admissions a year&#46; The mean number of beds in the ICU was 18&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#44; with an average of 500&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>349&#46;5 hospital beds&#46; In over one-half of the cases &#40;54&#46;4&#37;&#41;&#44; these data came from documented reliable sources&#44; while in 45&#46;6&#37; of the cases they represented estimates by the responders&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Questionnaire</span><p id="par0065" class="elsevierStylePara elsevierViewall">The answers to the questionnaire regarding albumin use are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Most of the professionals used albumin solutions either sporadically or not at all in the critical patient &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>55&#44; 96&#46;5&#37;&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">&#8220;Nutritional-metabolic&#8221; section</span><p id="par0070" class="elsevierStylePara elsevierViewall">With regard to the different diseases&#44; the use of albumin solutions in critical patients with protein denutrition was either sporadic or inexistent in 98&#46;2&#37; of the cases &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>56&#41;&#46; In the patients with hypoalbuminemia&#44; the use of albumin was likewise scarce or inexistent in most of the cases &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>54&#44; 94&#46;7&#37;&#41;&#46; Some professionals administered albumin when albuminemia was found to be within the following ranges&#58; 2&#8211;2&#46;5<span class="elsevierStyleHsp" style=""></span>g&#47;dl &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5 8&#46;8&#37;&#41;&#59; 1&#46;5&#8211;2<span class="elsevierStyleHsp" style=""></span>g&#47;dl &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#44; 21&#46;1&#37;&#41;&#59; and 1&#8211;1&#46;5<span class="elsevierStyleHsp" style=""></span>g&#47;dl &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#44; 10&#46;5&#37;&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Only three physicians used albumin solutions with nutrition&#58; two of them with parenteral nutrition and the other with both types of artificial nutrition &#40;enteral and parenteral&#41;&#46; Of these professionals&#44; only one occasionally used albumin solutions with insulin with the purpose of ensuring greater insulin fixation&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">&#8220;Hypovolemia&#47;hypovolemic shock&#8221; section</span><p id="par0080" class="elsevierStylePara elsevierViewall">In this section&#44; 49 responders &#40;86&#37;&#41; claimed to never or almost never use albumin for volume replacement or expansion&#44; not even in cases of hypovolemic shock&#46; Of the 7 responders who often or sometimes used albumin for volume replacement in the critical patient with hypovolemia&#47;hypovolemic shock&#44; the volume of albumin commonly administered was &#60;200<span class="elsevierStyleHsp" style=""></span>ml in two questionnaires &#40;3&#46;5&#37;&#41;&#44; 200&#8211;400<span class="elsevierStyleHsp" style=""></span>ml in four &#40;7&#37;&#41;&#44; and 800&#8211;1000<span class="elsevierStyleHsp" style=""></span>ml according to one questionnaire &#40;1&#46;8&#37;&#41;&#46; The concentration of the administered albumin solutions was 5&#37; in two questionnaires &#40;3&#46;5&#37;&#41; and 20&#37; in 6 &#40;10&#46;5&#37;&#41;&#46; The total albumin dose usually administered over 24<span class="elsevierStyleHsp" style=""></span>h to patients with hypovolemia&#47;hypovolemic shock was &#60;50<span class="elsevierStyleHsp" style=""></span>g in two questionnaires &#40;3&#46;5&#37;&#41;&#44; 50&#8211;100<span class="elsevierStyleHsp" style=""></span>g in two &#40;3&#46;5&#37;&#41;&#44; 100&#8211;200<span class="elsevierStyleHsp" style=""></span>g in two &#40;3&#46;5&#37;&#41;&#44; and &#62;200<span class="elsevierStyleHsp" style=""></span>g according to one questionnaire &#40;1&#46;8&#37;&#41;&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">&#8220;Sepsis&#47;septic shock&#8221; section</span><p id="par0085" class="elsevierStylePara elsevierViewall">Albumin solutions were never or almost never used in sepsis&#47;septic shock according to 49 responders &#40;86&#37;&#41;&#46; Only 7 physicians &#40;12&#46;3&#37;&#41; used albumin solutions occasionally or often in such situations &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; In these cases&#44; the volume administered was usually &#60;200<span class="elsevierStyleHsp" style=""></span>ml according to three questionnaires &#40;5&#46;3&#37;&#41;&#44; 200&#8211;400<span class="elsevierStyleHsp" style=""></span>ml in three &#40;5&#46;3&#37;&#41;&#44; and 400&#8211;600<span class="elsevierStyleHsp" style=""></span>ml in one questionnaire &#40;1&#46;8&#37;&#41;&#46; The concentration of the albumin solutions was 5&#37; according to one questionnaire &#40;1&#46;8&#37;&#41; and 20&#37; in 6 &#40;10&#46;5&#37;&#41;&#46; The total albumin dose usually administered by these professionals over 24<span class="elsevierStyleHsp" style=""></span>h in cases of sepsis&#47;septic shock was &#60;50<span class="elsevierStyleHsp" style=""></span>g according to one questionnaire &#40;1&#46;8&#37;&#41;&#44; 50&#8211;100<span class="elsevierStyleHsp" style=""></span>g in four questionnaires &#40;7&#37;&#41;&#44; 100&#8211;200<span class="elsevierStyleHsp" style=""></span>g in one &#40;1&#46;8&#37;&#41;&#44; and &#62;200<span class="elsevierStyleHsp" style=""></span>g in one questionnaire &#40;1&#46;8&#37;&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">&#8220;Hepatorenal&#8221; section</span><p id="par0090" class="elsevierStylePara elsevierViewall">Fifty ICUs &#40;87&#46;7&#37;&#41; used albumin in critical patients with liver disease and hypoalbuminemia&#46; Fifty-six responders &#40;98&#46;2&#37;&#41; administered albumin after evacuating paracentesis&#44; while 52 &#40;91&#46;2&#37;&#41; did so in patients with hepatorenal syndrome&#46; The aspects most taken into account by the professionals in administering albumin to critical patients with liver disease were&#58; volume of ascitic fluid evacuated at paracentesis &#40;51 responders&#44; 89&#46;5&#37;&#41;&#44; serum albumin &#40;29 responders&#44; 50&#46;9&#37;&#41; and diuresis &#40;28 responders&#44; 49&#46;1&#37;&#41;&#46; Twenty-eight physicians &#40;49&#46;1&#37;&#41; administered albumin to critical patients with anasarca before the administration of furosemide&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">&#8220;Other uses&#8221; section</span><p id="par0095" class="elsevierStylePara elsevierViewall">This section explored the use of plasmapheresis in the different hospital centers&#46; Forty-two centers &#40;73&#46;7&#37;&#41; claimed to use the technique&#46; One of the responders did not know whether plasmapheresis was performed with albumin in his center&#46; In the rest of the cases&#44; albumin solutions were used in the plasmapheresis sessions at least occasionally in 57&#46;9&#37; of the cases &#40;33 centers&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Among the indications of albumin not reflected in the questionnaire&#44; the options cited by the responders were liver dialysis with MARS<span class="elsevierStyleSup">&#174;</span> &#40;molecular adsorbent recirculating system&#41; in four questionnaires &#40;7&#37;&#41;&#44; oligoanuric renal failure with severe hypoalbuminemia &#40;&#60;1&#46;5<span class="elsevierStyleHsp" style=""></span>g&#47;dl&#41; in one &#40;1&#46;8&#37;&#41;&#44; non-continuous hemodialysis with hypotensive episodes and the intent to achieve negative water balance in one questionnaire &#40;1&#46;8&#37;&#41;&#44; hypoproteinemia in one &#40;1&#46;8&#37;&#41;&#44; and resuscitation in major burn victims in two questionnaires &#40;3&#44;5&#37;&#41;&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">&#8220;Clinical practice&#47;evidence&#8221; section</span><p id="par0105" class="elsevierStylePara elsevierViewall">This section was answered by 54 responders&#46; A large percentage of the professionals &#40;77&#46;2&#37;&#41; claimed to know the available scientific evidence regarding the use of albumin in critical patients without liver disease&#46; Nevertheless&#44; 3&#46;5&#37; preferred to rely on their own professional experience to establish the indication&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">On the other hand&#44; 57&#46;9&#37; of the responders considered that the use of albumin solutions never or almost never has a positive impact upon critical patients without liver disease&#44; while 31&#46;6&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>18&#41; agreed that albumin use always or generally could have a negative impact upon such patients&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">The majority of the professionals &#40;82&#46;5&#37;&#41; claimed to know the available scientific evidence regarding the use of albumin in critical patients with liver disease&#46; Three physicians preferred to rely on their own professional experience to establish the indication&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The prevalent opinion &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>49&#44; 86&#37;&#41; was that the use of albumin in patients with liver disease could exert a beneficial effect upon the clinical course&#44; and few considered that albumin in general could exert a negative effect &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#44; 10&#46;5&#37;&#41;&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">The most frequently used albumin vial volume was 50<span class="elsevierStyleHsp" style=""></span>ml according to 48 responders &#40;84&#46;2&#37;&#41;&#44; while the most commonly administered concentration was 20&#37; according to 49 responders &#40;86&#37;&#41;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Most of the responders were unaware of the price of the albumin solutions &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>35&#44; 61&#46;4&#37;&#41;&#44; and only 15&#46;8&#37; correctly estimated the price of a 50-ml vial of human albumin at a concentration of 20&#37;&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Almost one-half of the responders knew of no substitute for albumin solutions&#46; The most frequently identified substitutes were colloids &#40;43&#46;9&#37; of the responders&#41;&#46;</p></span></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Discussion</span><p id="par0140" class="elsevierStylePara elsevierViewall">The number of completed questionnaires constitutes a large sample reflecting routine practice in Spain&#44; though it might not be fully representative of the true situation&#44; since the ICUs were not selected on a random basis&#46; Nevertheless&#44; the answers were very homogeneous in practically all the analyzed areas&#44; and this in turn suggests that the survey effectively reflects routine practice regarding the use of albumin solutions&#46; The South American sample is of course too small to allow us to draw such conclusions&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">It would be interesting to repeat this study some years after its publication&#44; with a larger number of ICUs&#44; in order to determine whether the recent studies<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17&#44;18</span></a> on the utilization of albumin in septic patients lead to changes in the way in which albumin is used&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">The questionnaires were mainly answered by experienced intensivists working in medium to large centers and with a considerable number of ICU admissions each year&#46; In this setting&#44; albumin solutions were used sporadically or were not used in critical patients&#46; This observation persisted in the different sections of the questionnaire&#44; with the sole exception of the hepatorenal section&#46; Thus&#44; albumin was little used or not used at all in denutrition&#44; hypoalbuminemia&#44; hypovolemia and sepsis&#47;septic shock&#46; This is consistent with the general recommendations on albumin use&#46; <a class="elsevierStyleCrossRef" href="#tbl0040">Table 2</a> shows the level of evidence referred to the use of albumin solutions in the different sections of the questionnaire&#46;</p><elsevierMultimedia ident="tbl0040"></elsevierMultimedia><p id="par0155" class="elsevierStylePara elsevierViewall">The recently published consensus document of the European Society of Intensive Care on the use of colloids in the critical patient contemplates the possibility of administering albumin solutions in septic patients&#44; though their efficacy has not been firmly established&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> The more recent review of the management guides of the Surviving Sepsis Campaign recommend the administration of albumin in patients with septic shock who require large amounts of crystalloids&#44; with level of evidence 2C according to the Grading of Recommendations Assessment&#44; Development and Evaluation &#40;GRADE&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> This document has been published after the present survey&#44; and therefore could not be taken into account by the responders of the questionnaire&#46; In any case&#44; the evidence on the effectiveness of albumin in sepsis lacks the quality needed to allow its recommendation in severe sepsis&#47;septic shock&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">The indications of albumin are supported by a greater level of evidence in the case of hepatorenal disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;21</span></a> This is also reflected by the findings of our study&#46; In fact&#44; most of the responders used albumin solutions in patients with liver disease and hypoalbuminemia&#44; following evacuating paracentesis or in hepatorenal syndrome&#46; In deciding to use albumin&#44; the professionals mainly considered albuminemia&#44; diuresis and the volume of ascitic fluid collected at paracentesis&#46; Indeed&#44; the volume of ascitic fluid collected at paracentesis establishes the indication of albumin administration&#46; Cirrhotic patients with spontaneous bacterial peritonitis or type I hepatorenal syndrome could also benefit from the administration of albumin solutions&#44; though there are no other indications for albumin use in these patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;20</span></a> However&#44; although there is no scientific evidence warranting the indication of albumin associated to furosemide in patients with anasarca&#44; the results of our study show that almost one-half of the responders used this combination&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Plasmapheresis was available in a large percentage of the centers in our study&#44; and in over one-half of the cases albumin solutions were used to replace the extracted plasma&#46; Based on the available evidence&#44; the use of albumin during plasmapheresis involving the extraction of over 20<span class="elsevierStyleHsp" style=""></span>ml of plasma&#47;kg body weight in a single session&#44; or 20<span class="elsevierStyleHsp" style=""></span>ml&#47;kg&#47;week in several consecutive sessions&#44; is considered adequate&#46; When the volumes are smaller&#44; the indication of albumin should be established on an individualized basis&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16&#44;22</span></a> In our survey we requested no information on the indications of plasmapheresis with albumin in relation to the needs referred to volume exchange&#46; However&#44; over 28&#37; of the responders claimed that plasmapheresis sessions were always or almost always performed with albumin&#46; We do not know whether there was precise knowledge of the technique on the part of the responders in each center&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Most of the responders considered that albumin use complies with the current recommendations referred to critical patients without liver disease&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> Furthermore&#44; most of the responders were of the opinion that albumin has no positive impact upon the patients&#44; and indeed could even have a negative effect&#46; The available literature does not offer conclusive proof that albumin reduces the mortality rate among patients with hypovolemia&#44; burns and hypoproteinemia&#44; although there is also no proof that it might increase the mortality risk&#46; Consequently&#44; the scant use of albumin in these patients is consistent with the scientific evidence&#46; The degree of dissatisfaction on the part of the professionals regarding the scientific literature supports the need to conduct well-designed studies with homogeneous populations and adequate sample sizes&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Although the studies conducted to date have not confirmed the positive or negative effect which albumin use might have&#44; in the subgroup of patients with severe traumatic brain injury &#40;TBI&#41; of the SAFE study&#44;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> the administration of albumin was associated to greater mortality than resuscitation performed with physiological saline solution &#40;OR 1&#46;8&#59; 95&#37;CI 1&#46;31&#8211;2&#46;70&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; In our survey we did not ask about the management of patients with TBI&#44; though considering the scant use of albumin in the resuscitation of critical patients&#44; similar considerations probably could also be extrapolated to severe TBI&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">In critical patients with liver disease&#44; the levels of evidence referred to albumin use are higher&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;21</span></a> This is related to the fact that in this case there are more studies with an adequate design and with more homogeneous populations&#46; In this regard&#44; our study shows that in the case of critical patients with liver disease&#44; the evidence was more widely known among the responders and guided albumin use more often&#46; The belief that at least in some cases albumin use could have a positive effect was more prevalent in the case of these patients&#44; and the belief that it might have a negative impact was less prevalent&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">The need for more studies with adequate designs&#44; the low levels of evidence referred to albumin use in most critical situations&#44; and the lack of knowledge of the effects of albumin upon mortality undoubtedly condition the habits regarding albumin use and which are still found in the routine practice of some ICUs&#44; despite the absence of adequate degrees of recommendation&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">In order to obtain more information on routine clinical practice&#44; we asked about the albumin vials commonly used in the ICUs&#46; In this respect&#44; the vials were found to contain 50<span class="elsevierStyleHsp" style=""></span>ml of albumin solution at a concentration of 5 or 20&#37;&#46; In general&#44; the available presentations and concentrations of albumin were known to the professionals&#46; Few of the responders in our study used concentrations not found on the market&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Regarding knowledge of the cost of albumin use&#44; the questionnaire asked about the price of the vials&#46; The price of a 50-ml vial containing 20&#37; albumin ranges from 37&#46;45 to 44&#46;87 euros &#40;updated prices in Medimecum 2010<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a>&#41;&#46; A large percentage of the responders did not know the cost of albumin&#44; and only 15&#46;8&#37; offered an adequate price estimate of between 30 and 50 euros&#46; The cost of the albumin solutions therefore does not seem to be particularly important in deciding to use such products&#44; since most of the professionals were unaware of the price of the vials&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Among the substitutes of albumin solutions&#44; a large percentage of the responders &#40;43&#46;9&#37;&#41; cited colloids &#40;starches&#44; dextrans and gelatins&#41; as an alternative&#46; Colloids are used in routine clinical practice mainly for resuscitation in hypovolemia &#40;absolute or relative&#41;&#44; although there is controversy regarding the type of fluid indicated in such cases&#44; and at present colloids are not considered to be better than crystalloids&#46; This is another issue requiring further clarification&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a></p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Conclusions</span><p id="par0205" class="elsevierStylePara elsevierViewall">The use of human albumin solutions is not recognized as a common practice among physicians attending critical patients&#44; except in the case of subjects with liver disease&#46; Knowledge of the available scientific evidence is reported to be widespread among these physicians&#46; In general&#44; the opinions on the use of albumin solutions are consistent with the established recommendations&#44; particularly in patients with liver disease&#44; and their utilization in the ICU is guided by the available evidence&#46; Professional experience conditions the decision to use albumin&#8211;the mentioned recommendations prevailing only among a minority of professionals&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0170">Conflicts of interest</span><p id="par0210" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:2 [
          "identificador" => "xres373973"
          "titulo" => array:8 [
            0 => "Abstract"
            1 => "Background"
            2 => "Objectives"
            3 => "Design"
            4 => "Period"
            5 => "Methods"
            6 => "Results"
            7 => "Conclusions"
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec353022"
          "titulo" => "Keywords"
        ]
        2 => array:2 [
          "identificador" => "xres373974"
          "titulo" => array:9 [
            0 => "Resumen"
            1 => "Introducci&#243;n"
            2 => "Objetivo"
            3 => "Dise&#241;o"
            4 => "Periodo"
            5 => "&#193;mbito"
            6 => "M&#233;todos"
            7 => "Resultados"
            8 => "Conclusiones"
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec353021"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Patients and methods"
        ]
        6 => array:3 [
          "identificador" => "sec0015"
          "titulo" => "Results"
          "secciones" => array:1 [
            0 => array:3 [
              "identificador" => "sec0020"
              "titulo" => "Data referred to the professional"
              "secciones" => array:8 [
                0 => array:2 [
                  "identificador" => "sec0025"
                  "titulo" => "Data referred to the hospital center"
                ]
                1 => array:2 [
                  "identificador" => "sec0030"
                  "titulo" => "Questionnaire"
                ]
                2 => array:2 [
                  "identificador" => "sec0035"
                  "titulo" => "&#8220;Nutritional-metabolic&#8221; section"
                ]
                3 => array:2 [
                  "identificador" => "sec0040"
                  "titulo" => "&#8220;Hypovolemia&#47;hypovolemic shock&#8221; section"
                ]
                4 => array:2 [
                  "identificador" => "sec0045"
                  "titulo" => "&#8220;Sepsis&#47;septic shock&#8221; section"
                ]
                5 => array:2 [
                  "identificador" => "sec0050"
                  "titulo" => "&#8220;Hepatorenal&#8221; section"
                ]
                6 => array:2 [
                  "identificador" => "sec0055"
                  "titulo" => "&#8220;Other uses&#8221; section"
                ]
                7 => array:2 [
                  "identificador" => "sec0060"
                  "titulo" => "&#8220;Clinical practice&#47;evidence&#8221; section"
                ]
              ]
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0065"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0070"
          "titulo" => "Conclusions"
        ]
        9 => array:2 [
          "identificador" => "sec0075"
          "titulo" => "Conflicts of interest"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2013-05-16"
    "fechaAceptado" => "2013-08-28"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec353022"
          "palabras" => array:4 [
            0 => "Survey"
            1 => "Albumin solutions"
            2 => "Clinical practice"
            3 => "Critically ill patient"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec353021"
          "palabras" => array:4 [
            0 => "Encuesta"
            1 => "Soluciones de alb&#250;mina"
            2 => "Pr&#225;ctica cl&#237;nica"
            3 => "Paciente cr&#237;tico"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Human albumin solutions are used in a number of disorders&#44; though their indications are not clear in all circumstances&#46; These solutions are costly&#44; and their benefit has not been established in all settings&#46; It is therefore interesting to assess the presence of albumin solutions in the daily clinical practice of critical care professionals&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0015">Objectives</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">To report the standard clinical practices and to describe the variability of albumin solutions use in critically ill patients&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0020">Design</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">A survey sent by e-mail to Spanish and South American Intensive Care Units &#40;ICUs&#41;</p> <span class="elsevierStyleSectionTitle" id="sect0025">Period</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Planning and execution were during the year 2012&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0030">Methods</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">A questionnaire comprising of 35 questions&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0035">Results</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Fifty-seven surveys were analyzed&#46; The use of albumin solutions was sporadic or negligible in critically ill patients &#40;96&#46;5&#37;&#41;&#46; The exceptions were patients with liver disease &#40;87&#46;7&#37; of the responders administered albumin to these patients&#41;&#46; A high percentage of professionals claimed to know the available scientific evidence on the use of albumin in patients with liver disease &#40;82&#46;5&#37;&#41; and in patients without liver disease &#40;77&#46;2&#37;&#41;&#46; Only 5&#46;3&#37; of the responders preferred to rely on their own experience to establish the indications of albumin use&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0040">Conclusions</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">The use of albumin solutions is infrequent in ICUs&#44; except in patients with liver disease&#46; Evidence-based knowledge on albumin use is declared to be extensive in ICUs&#46; As a rule&#44; opinions on the use of albumin solutions are based on the scientific recommendations&#44; especially in patients with liver disease&#46; Professional experience rarely prevails over the published clinical guidelines&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0050">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Las soluciones de alb&#250;mina humana se emplean en diversas enfermedades&#44; aunque su indicaci&#243;n no es clara en todas&#46; Presentan un coste elevado y su beneficio no se encuentra plenamente establecido&#46; Resulta interesante conocer cu&#225;l es la presencia de las soluciones de alb&#250;mina en la pr&#225;ctica cl&#237;nica diaria de los intensivistas&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0055">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Documentar pr&#225;cticas cl&#237;nicas habituales y describir la variabilidad de las mismas en cuanto al empleo de soluciones de alb&#250;mina en enfermos cr&#237;ticos&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0060">Dise&#241;o</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Encuesta enviada mediante correo electr&#243;nico a unidades de cuidados intensivos &#40;UCI&#41; espa&#241;olas y sudamericanas&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0065">Periodo</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Planificaci&#243;n y realizaci&#243;n durante el a&#241;o 2012&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0070">&#193;mbito</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">UCI espa&#241;olas y sudamericanas&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0075">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Cuestionario de 35 preguntas&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0080">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se han analizado 57 encuestas&#46; El empleo de las soluciones de alb&#250;mina fue espor&#225;dico o no se empleaba en el paciente cr&#237;tico &#40;96&#44;5&#37;&#41;&#46; La excepci&#243;n fueron los pacientes hepat&#243;patas &#40;un 87&#44;7&#37; de los encuestados la administraba&#41;&#46; Un elevado porcentaje declar&#243; conocer la evidencia cient&#237;fica disponible sobre el empleo de alb&#250;mina en pacientes hepat&#243;patas &#40;82&#44;5&#37;&#41; y no hepat&#243;patas &#40;77&#44;2&#37;&#41;&#46; El 5&#44;3&#37; de los encuestados prefer&#237;a basarse en su experiencia para establecer las indicaciones del empleo de alb&#250;mina&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0085">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El empleo de soluciones de alb&#250;mina no es frecuente en las UCI&#44; salvo en pacientes hepat&#243;patas&#46; Los profesionales del enfermo cr&#237;tico manifiestan tener un amplio conocimiento de la evidencia cient&#237;fica&#46; Las opiniones emitidas&#44; acerca del empleo de alb&#250;mina&#44; son acordes con las recomendaciones establecidas&#44; sobre todo&#44; en pacientes hepat&#243;patas&#46; La experiencia profesional prevalece en escasas ocasiones sobre las recomendaciones publicadas&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Est&#233;banez-Montiel MB&#44; Quintana-D&#237;az M&#44; Garc&#237;a de Lorenzo y Mateos A&#44; Blancas Gomez-Casero R&#44; Acosta-Escribano J&#44; Marcos-Neira P&#44; et al&#46; Resultados de una encuesta sobre la pr&#225;ctica cl&#237;nica habitual en el empleo de alb&#250;mina en UCI&#46; Med Intensiva&#46; 2014&#59;38&#58;403&#8211;412&#46;</p>"
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0215" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Andalusia</span>&#58; Pilar Mart&#237;nez &#40;Hospital de Puerto Real&#44; C&#225;diz&#41;&#59; Antonio Valverde &#40;Hospital Virgen de la Victoria&#44; M&#225;laga&#41;&#59; Manuel Herrera&#44; Juan Fern&#225;ndez &#40;Hospital Carlos Haya&#44; M&#225;laga&#41;&#59; Carlos Ortiz&#44; Juan Jos&#233; Egea &#40;Hospital Virgen del Roc&#237;o&#44; Sevilla&#41;&#59; Juan M&#225;rquez &#40;Hospital de la Macarena&#44; Sevilla&#41;&#46; <span class="elsevierStyleItalic">Arag&#243;n</span>&#58; Carlos Gonz&#225;lez &#40;Hospital de Barbastro&#44; Barbastro&#41;&#59; Carlos Ser&#243;n &#40;Hospital San Jorge&#44; Huesca&#41;&#46; <span class="elsevierStyleItalic">Asturias</span>&#58; Jos&#233; Antonio Gonzalo &#40;Hospital Central de Asturias&#44; Oviedo&#41;&#46; <span class="elsevierStyleItalic">Brasil</span>&#58; Val&#233;ria Abrah&#227;o &#40;Hospital Ipanema Plus&#44; R&#237;o de Janeiro&#41;&#46; <span class="elsevierStyleItalic">Castilla</span><span class="elsevierStyleBold">-</span><span class="elsevierStyleItalic">La Mancha</span>&#58; Ana Bueno &#40;Hospital General de Ciudad Real&#44; Ciudad Real&#41;&#59; Elena Gonz&#225;lez &#40;Hospital Virgen de la Luz&#44; Cuenca&#41;&#59; Miguel &#193;ngel Taberna &#40;Hospital Nuestra Se&#241;ora del Prado&#44; Talavera de la Reina&#41;&#59; Marcelino S&#225;nchez &#40;Hospital Virgen de la Salud&#44; Toledo&#41;&#59; Francisca Prieto &#40;Hospital de Santa B&#225;rbara&#44; Puertollano&#41;&#59; Jaime Serrano &#40;Hospital General La Mancha-Centro&#44; Alc&#225;zar de San Juan&#41;&#59; Sergio S&#225;ez&#44; Concepci&#243;n Garc&#237;a &#40;Hospital Provincial de la Misericordia&#44; Toledo&#41;&#46; <span class="elsevierStyleItalic">Castilla</span><span class="elsevierStyleBold">-</span><span class="elsevierStyleItalic">Le&#243;n</span>&#58; Miriam Ochoa &#40;Hospital Cl&#237;nico Universitario de Salamanca&#44; Salamanca&#41;&#59; Sopetr&#225;n Rey&#44; Mar&#237;a Jes&#250;s L&#243;pez&#44; Santiago Mac&#237;as&#44; Patricia Jimeno &#40;Hospital General de Segovia&#44; Segovia&#41;&#59; Vicente Mor&#225;n &#40;Complejo Hospitalario de Le&#243;n&#44; Le&#243;n&#41;&#59; Teresita Loreto &#40;Hospital Virgen de la Concha&#44; Zamora&#41;&#46; <span class="elsevierStyleItalic">Catalonia</span>&#58; Alberto Sanduimenge &#40;Hospital Universitari Joan <span class="elsevierStyleSmallCaps">XXIII</span>&#44; Tarragona&#41;&#59; Luis Servi&#225; &#40;Hospital Arnau de Vilanova&#44; L&#233;rida&#41;&#59; Carol Lorencia&#44; Alfonso Bonet &#40;Hospital Universitari Doctor Josep Trueta&#44; Gerona&#41;&#59; &#193;ngel Robles &#40;Hospital Vall d¿Hebron&#44; Barcelona&#41;&#59; Ferr&#225;n Roche &#40;Hospital Sant Pau&#44; Barcelona&#41;&#59; Carles Ferrer &#40;Hospital M&#250;tua de Terrasa&#44; Tarrasa&#41;&#59; Luisa Bordel &#40;Hospital Universitari Germans Trias i Pujol&#44; Badalona&#41;&#46; <span class="elsevierStyleItalic">Chile</span>&#58; Darwin Acosta &#40;Hospital Cl&#237;nico Mutual&#44; Iquique&#41;&#46; <span class="elsevierStyleItalic">Extremadura</span>&#58; Marta Montans &#40;Hospital San Pedro de Alc&#225;ntara&#44; C&#225;ceres&#41;&#46; <span class="elsevierStyleItalic">Balearic Islands</span>&#58; Carlos Ant&#243;n &#40;Hospital de Manacor&#44; Manacor&#41;&#59; Isabel Ceniceros &#40;Cl&#237;nica ISP Palmaplanas&#44; Palma de Mallorca&#41;&#46; <span class="elsevierStyleItalic">La Rioja</span>&#58; Mar&#237;a Mac&#237;as &#40;Hospital de San Pedro&#44; Logro&#241;o&#41;&#46; <span class="elsevierStyleItalic">Madrid</span>&#58; Blanca L&#243;pez Matamala &#40;Hospital Universitario del Tajo&#44; Aranjuez&#41;&#59; Fernando Monasterio&#44; Manuel S&#225;nchez &#40;Hospital Universitario de la Princesa&#44; Madrid&#41;&#59; Amalia de la G&#225;ndara &#40;Hospital Infanta Leonor&#44; Madrid&#41;&#59; Vicente G&#243;mez &#40;Hospital Moncloa&#44; Madrid&#41;&#59; Juan Carlos Montejo &#40;Hospital 12 de Octubre&#44; Madrid&#41;&#59; Antonio Blesa &#40;Hospital Cl&#237;nico de San Carlos&#44; Madrid&#41;&#59; Jos&#233; &#193;ngel Lorente &#40;Hospital Universitario de Getafe&#44; Getafe&#41;&#59; Clara Vaquerizo &#40;Hospital Fundaci&#243;n Fuenlabrada&#44; Fuenlabrada&#41;&#59; Pedro Gald&#243;s &#40;Hospital Universitario Puerta de Hierro&#44; Majadahonda&#41;&#59; Patricia Albert &#40;Hospital Universitarios del Sureste&#44; Arganda&#41;&#59; Alberto Hern&#225;ndez &#40;Hospital Universitario Fundaci&#243;n Alcorc&#243;n&#44; Alcorc&#243;n&#41;&#59; &#193;ngela Algaba &#40;Hospital Universitario de Torrej&#243;n&#44; Torrej&#243;n de Ardoz&#41;&#59; Jorge L&#243;pez &#40;Hospital Severo Ochoa&#44; Legan&#233;s&#41;&#46; <span class="elsevierStyleItalic">Murcia</span>&#58; Francisco Garc&#237;a &#40;Hospital General Universitario Los Arcos del Mar Menor&#44; San Javier&#41;&#59; Carmen S&#225;nchez &#40;Hospital General Universitario Reina Sof&#237;a&#44; Murcia&#41;&#46; <span class="elsevierStyleItalic">Navarre</span>&#58; Laura Macaya &#40;Hospital General de Navarra&#44; Pamplona&#41;&#46; <span class="elsevierStyleItalic">Basque Country</span>&#58; Mar&#237;a Mercedes Zabarte &#40;Hospital Donostia&#44; San Sebasti&#225;n&#41;&#46; <span class="elsevierStyleItalic">Valencia</span>&#58; Manuel Cervera &#40;Hospital Arnau de Vilanova&#44; Valencia&#41;&#59; Alfonso Mesejo &#40;Hospital Cl&#237;nico&#44; Valencia&#41;&#59; Miguel &#193;ngel Garc&#237;a &#40;Hospital de Torrevieja&#44; Torrevieja&#41;&#59; Jos&#233; Antonio Acosta &#40;Hospital General de Alicante&#44; Alicante&#41;&#59; Bego&#241;a Balerdi&#44; Remedios Clemente &#40;Hospital La Fe&#44; Valencia&#41;&#59; Lid&#243;n Mateu &#40;Hospital General de Castell&#243;n&#44; Castell&#243;n&#41;&#46; <span class="elsevierStyleItalic">Venezuela</span>&#58; Tully Baptista &#40;Hospital Universitario&#44; Caracas&#41;&#46;</p>"
            "etiqueta" => "Appendix A"
            "titulo" => "List of collaborators in the responding centers"
            "identificador" => "sec0080"
          ]
        ]
      ]
    ]
    "multimedia" => array:2 [
      0 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Ig&#58; immunoglobulins&#59; EN&#58; enteral nutrition&#59; PN&#58; parenteral nutrition&#59; FFP&#58; fresh frozen plasma&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Questionnaire</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Questions</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Answers</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">&#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;1&#41; Do you regularly use albumin solutions in the treatment of critical patients&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">03&#46;549&#46;147&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Nutritional-metabolic</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;2&#41; Do you regularly use albumin solutions in the case of critical patients with protein denutrition&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">01&#46;819&#46;378&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;3&#41; Do you regularly use albumin solutions in the case of critical patients with hypoalbuminemia&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">05&#46;335&#46;159&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;4&#41; If you use albumin solutions in patients with hypoalbuminemia&#44; from what serum albumin concentration do you decide to administer them&#63; &#40;g&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#8211;3&#46;52&#46;5&#8211;32&#8211;2&#46;51&#46;5&#8211;21&#8211;1&#46;5&#60;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">008&#46;821&#46;110&#46;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;5&#41; Do you administer albumin with critical patient nutrition&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">005&#46;394&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;6&#41; If you administer albumin with nutrition&#44; what types of nutrition do you use&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enteral nutritionParenteral nutritionBoth&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">03&#46;51&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;7&#41; If you use albumin solutions in these cases&#44; do you do so added to insulin for improved fixation&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0003&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hypovolemia&#47;hypovolemic shock</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;8&#41; Do you regularly use albumin solutions in the case of critical patients requiring volume replacement&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">01&#46;810&#46;586&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;9&#41; Do you regularly use albumin solutions in the case of critical patients with hypovolemic shock&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">01&#46;810&#46;586&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;10&#41; If you use albumin solutions in hypovolemia&#47;hypovolemic shock&#44; the volume you usually administer is &#40;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;200200&#8211;400400&#8211;600600&#8211;800800&#8211;1000&#62;1000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;57001&#46;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;11&#41; At what concentration do you administer albumin in these cases&#63; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52025Diluted&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;5 10&#46;500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;12&#41; The total albumin dose over 24<span class="elsevierStyleHsp" style=""></span>h which you usually use in patients with hypovolemia&#47;hypovolemic shock is &#40;g&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8804;5050&#8211;100100&#8211;200&#62;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;53&#46;5 3&#46;51&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Sepsis&#47;septic shock</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;13&#41; Do you regularly use albumin solutions in the case of critical patients with sepsis&#47;septic shock&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">01&#46;810&#46;586&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;14&#41; If you use albumin solutions in sepsis&#47;septic shock&#44; the volume you usually administer is &#40;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;200200&#8211;400400&#8211;600600&#8211;800800&#8211;1000&#62;1000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;35&#46;31&#46;8000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;15&#41; At what concentration do you administer albumin in these cases&#63; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52025Diluted&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;810&#46;500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;16&#41; The total albumin dose over 24<span class="elsevierStyleHsp" style=""></span>h which you usually use in patients with sepsis&#47;septic shock is &#40;g&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8804;5050&#8211;100100&#8211;200&#62;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;871&#46;81&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hepatorenal</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;17&#41; Do you regularly use albumin solutions in the case of critical patients with liver disease and hypoalbuminemia&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;521&#46;156&#46;112&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;18&#41; Do you regularly use albumin solutions in the case of critical patients with liver disease subjected to evacuating paracentesis&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#46;631&#46;6141&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;19&#41; Do you regularly use albumin solutions in the case of critical patients with liver disease and hepatorenal syndrome&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;324&#46;640&#46;48&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;20&#41; You use albumin solutions in patients with liver disease considering the following parameters&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Serum albuminTotal blood proteinsAge and basal conditionPatient nutritional conditionVolemiaDiuresisVolume of ascitic fluid at paracentesisOthers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#46;910&#46;512&#46;31428&#46;149&#46;189&#46;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;21&#41; Do you regularly use albumin solutions in the case of critical patients with anasarca before the administration of furosemide&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;3736&#46;850&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Other uses</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;22&#41; Is plasmapheresis performed in your center&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YesNo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#46;726&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;23&#41; If your center performs plasmapheresis&#44; is replacement made with albumin solutions&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;1722&#46;814&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;24&#41; If you use albumin solutions in relation to other indications not mentioned in this questionnaire&#44; please specify which indications&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MARS<span class="elsevierStyleSup">&#174;</span>Resuscitation in major burnsOligoanuric renal failure with severe hypoalbuminemia &#40;&#60;1&#46;5<span class="elsevierStyleHsp" style=""></span>g&#47;dl&#41;Non-continuous hemodialysis with hypotensive episodes and the intent to achieve negative water balanceHypoproteinemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#46;51&#46;81&#46;81&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Clinical practice&#47;evidence</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;25&#41; Do you know the available scientific evidence referred to the use of albumin solutions in critical patients without liver disease&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; it is clear in this respectYes&#44; but it does not clarify the usual doubtsYes&#44; but I prefer to rely on my own experienceNo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;347&#46;43&#46;517&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;26&#41; Do you think the use of albumin solutions can have a positive effect upon the prognosis of critical patients without liver disease&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">01&#46;8035&#46;157&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;27&#41; The routine use of albumin solutions can have a negative impact upon critical patients without liver disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">I fully agreeI generally agreeI neither agree nor disagreeI sometimes agreeI rarely agreeI disagree&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;319&#46;329&#46;821&#46;11&#46;810&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;28&#41; Do you know the available scientific evidence referred to the use of albumin solutions in critical patients with liver disease&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; it is clear in this respectYes&#44; but it does not clarify the usual doubtsYes&#44; but I prefer to rely on my own experienceNo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&#46;933&#46;35&#46;312&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;29&#41; Do you think the use of albumin solutions can have a positive effect upon the prognosis of critical patients with liver disease&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;817&#46;559&#46;68&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;30&#41; The routine use of albumin solutions can have a negative impact upon critical patients with liver disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">I fully agreeI generally agreeI neither agree nor disagreeI sometimes agreeI rarely agreeI disagree&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">010&#46;510&#46;533&#46;312&#46;328&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;31&#41; If you administer albumin solutions&#44; the volume of the vials you use is &#40;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1050100250500Others&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">084&#46;275&#46;31&#46;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;32&#41; If you administer albumin solutions&#44; the albumin concentration you usually use is &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35152025Diluted&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;810&#46;51&#46;8863&#46;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;33&#41; Do you know the price of the albumin solutions&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YesNo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#46;361&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;34&#41; If you do not know the price of the albumin solutions&#44; you estimate that a vial containing 50<span class="elsevierStyleHsp" style=""></span>ml of albumin 20&#37; costs &#40;&#8364;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8804;1010&#8211;3030&#8211;50&#62;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;85&#46;315&#46;831&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;35&#41; Do you know any substitutes of albumin solutions&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#46; Which&#63;&#8211; Colloids&#8211; FFP&#8211; Ig&#8211; EN and PNNo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#46;443&#46;98&#46;81&#46;81&#46;847&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab565991.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Full-submitted questionnaire and answers received&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl0040"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">GRADE system<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a>&#58; Evaluates the strength of recommendation as A &#40;strong&#41; or B &#40;weak&#41;&#44; and the quality of evidence as high &#40;it is unlikely for the results of new studies to modify confidence in estimation of the effect&#41;&#44; moderate &#40;estimation of the effect is probably close to the real effect&#44; but there might be substantial differences&#41;&#44; low &#40;new studies are likely to modify confidence in estimation of the effect and its magnitude&#41;&#44; or very low &#40;any estimation of effect is very uncertain&#41;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Disease condition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Levels of evidence &#40;GRADE&#41;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Isolated hypoalbuminemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No evidence<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hypovolemia&#47;hypovolemic shock&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No evidence<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6&#44;24</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sepsis&#47;septic shock&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2B<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a>&#8211;2C<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Paracentesis in large volume ascites in cirrhotic patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1A<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Type I hepatorenal syndrome &#40;with terlipressin&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1A<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Plasmapheresis with large volume plasma exchange&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Consensus exists<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab565992.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Levels of evidence referred to the use of albumin solutions in the different sections of the questionnaire&#44; according to the available recommendations&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:25 [
            0 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Albumin Reviewers&#46; Soluci&#243;n de alb&#250;mina humana para la reanimaci&#243;n y la expansi&#243;n de volumen en pacientes cr&#237;ticos &#40;Revisi&#243;n Cochrane traducida&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Alderson"
                            1 => "F&#46; Bunn"
                            2 => "C&#46; Lefebvre"
                            3 => "A&#46; Li Wan Po"
                            4 => "L&#46; Li"
                            5 => "I&#46; Roberts"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "titulo" => "La Biblioteca Cochrane Plus&#44; 2008 N&#250;mero 4"
                        "fecha" => "2008"
                        "editorial" => "Update Software Ltd&#46;"
                        "editorialLocalizacion" => "Oxford"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Human albumin administration in critically ill patients&#58; systematic review of randomised controlled trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Cochrane Injuries Group Albumin Reviewers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "1998"
                        "volumen" => "317"
                        "paginaInicial" => "235"
                        "paginaFinal" => "240"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9677209"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Human albumin solution for resuscitation and volume expansion in critically ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "F&#46; Bunn"
                            1 => "C&#46; Lefebvre"
                            2 => "A&#46; Li Wan Po"
                            3 => "L&#46; Li"
                            4 => "I&#46; Roberts"
                            5 => "G&#46; Schierhout"
                            6 => "The Albumin Reviewers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/14651858.CD001208"
                      "Revista" => array:5 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2000"
                        "volumen" => "2"
                        "paginaInicial" => "CD001208"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10796756"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Human albumin solution for resuscitation and volume expansion in critically ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Alderson"
                            1 => "F&#46; Bunn"
                            2 => "C&#46; Lefebvre"
                            3 => "W&#46;P&#46; Li"
                            4 => "L&#46; Li"
                            5 => "I&#46; Roberts"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/14651858.CD001208.pub4"
                      "Revista" => array:4 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2002"
                        "paginaInicial" => "CD001208"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22071799"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient survival after human albumin administration&#46; A meta-analysis of randomized&#44; controlled trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;M&#46; Wilkes"
                            1 => "R&#46;J&#46; Navickis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "2001"
                        "volumen" => "135"
                        "paginaInicial" => "149"
                        "paginaFinal" => "164"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11487482"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A comparison of albumin and saline for fluid resuscitation in the intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Finfer"
                            1 => "R&#46; Bellomo"
                            2 => "N&#46; Boyce"
                            3 => "J&#46; French"
                            4 => "J&#46; Myburgh"
                            5 => "R&#46; Norton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa040232"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2004"
                        "volumen" => "350"
                        "paginaInicial" => "2247"
                        "paginaFinal" => "2256"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15163774"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Albumin administration&#58; what is the evidence of clinical benefit&#46; A systematic review of randomized controlled trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46;R&#46; Haynes"
                            1 => "R&#46;J&#46; Navickis"
                            2 => "M&#46;M&#46; Wilkes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Anaesthesiol"
                        "fecha" => "2003"
                        "volumen" => "20"
                        "paginaInicial" => "771"
                        "paginaFinal" => "793"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14580047"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Morbidity in hospitalized patients receiving human albumin&#58; a metaanalysis of randomized&#44; controlled trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;L&#46; Vincent"
                            1 => "R&#46;J&#46; Navickis"
                            2 => "M&#46;M&#46; Wilkes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2004"
                        "volumen" => "32"
                        "paginaInicial" => "2029"
                        "paginaFinal" => "2038"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15483411"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of albumin in the intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;J&#46; Dubois"
                            1 => "J&#46;L&#46; Vincent"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Opin Crit Care"
                        "fecha" => "2002"
                        "volumen" => "8"
                        "paginaInicial" => "299"
                        "paginaFinal" => "301"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12386489"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Human albumin solution for resuscitation and volume expansion in critically ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Liberati"
                            1 => "L&#46; Moja"
                            2 => "I&#46; Moschetti"
                            3 => "G&#46;F&#46; Gensini"
                            4 => "R&#46; Gusinu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Intern Emerg Med"
                        "fecha" => "2006"
                        "volumen" => "1"
                        "paginaInicial" => "243"
                        "paginaFinal" => "245"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17120476"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Albumin administration improves organ function in critically ill hypoalbuminemic patients&#58; a prospective&#44; randomized&#44; controlled&#44; pilot study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; Dubois"
                            1 => "C&#46; Orellana-Jimenez"
                            2 => "C&#46; Melot"
                            3 => "D&#46; de Backer"
                            4 => "J&#46; Berre"
                            5 => "M&#46; Leeman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.CCM.0000239119.57544.0C"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2006"
                        "volumen" => "34"
                        "paginaInicial" => "2536"
                        "paginaFinal" => "2540"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16915107"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Saline or albumin for fluid resuscitation in patients with traumatic brain injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "The SAFE Study Investigators"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa067514"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2007"
                        "volumen" => "357"
                        "paginaInicial" => "874"
                        "paginaFinal" => "884"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17761591"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is albumin administration in the acutely ill associated with increased mortality&#63; Results of the SOAP study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;L&#46; Vincent"
                            1 => "Y&#46; Sakr"
                            2 => "K&#46; Reinhart"
                            3 => "C&#46;L&#46; Sprung"
                            4 => "H&#46; Gerlach"
                            5 => "V&#46;M&#46; Ranieri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/cc3895"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2005"
                        "volumen" => "9"
                        "paginaInicial" => "R745"
                        "paginaFinal" => "R754"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16356223"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of albumin as a resuscitation fluid for patients with sepsis&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;P&#46; Delaney"
                            1 => "A&#46; Dan"
                            2 => "J&#46; McCaffrey"
                            3 => "S&#46; Finfer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CCM.0b013e3181ffe217"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2011"
                        "volumen" => "39"
                        "paginaInicial" => "386"
                        "paginaFinal" => "391"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21248514"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Specific antioxidant properties of human serum albumin"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Taverna"
                            1 => "A&#46;L&#46; Marie"
                            2 => "J&#46;P&#46; Mira"
                            3 => "B&#46; Guidet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/2110-5820-3-4"
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Intensive Care"
                        "fecha" => "2013"
                        "volumen" => "3"
                        "paginaInicial" => "4"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23414610"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recommendations for the use of albumin and immunoglobulins"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46; Limbruno"
                            1 => "A&#46; Bennardello Lattanzio"
                            2 => "P&#46; Piccoli"
                            3 => "G&#46; Rossetti"
                            4 => "Italian Society of Transfusion Medicine and Immunohaematology &#40;SIMTI&#41;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2450/2009.0094-09"
                      "Revista" => array:7 [
                        "tituloSerie" => "Blood Transfus"
                        "fecha" => "2009"
                        "volumen" => "7"
                        "paginaInicial" => "216"
                        "paginaFinal" => "234"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19657486"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0735109709012121"
                          "estado" => "S300"
                          "issn" => "07351097"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Surviving sepsis campaign&#58; international guidelines for management of severe sepsis and septic shock&#58; 2012"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;P&#46; Dellinger"
                            1 => "M&#46;M&#46; Levy"
                            2 => "A&#46; Rhodes"
                            3 => "D&#46; Annane"
                            4 => "H&#46; Gerlach"
                            5 => "S&#46;M&#46; Opal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2013"
                        "volumen" => "4"
                        "paginaInicial" => "580"
                        "paginaFinal" => "637"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Consensus statement of the ESICM task force on colloid volume therapy in critically ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Konrad"
                            1 => "P&#46; Anders"
                            2 => "L&#46;S&#46; Charles"
                            3 => "J&#46; Roman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-012-2472-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2012"
                        "volumen" => "38"
                        "paginaInicial" => "368"
                        "paginaFinal" => "383"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22323076"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nuevas recomendaciones sobre la utilizaci&#243;n de soluciones de alb&#250;mina humana en pacientes con sepsis grave y shock s&#233;ptico&#46; Una evaluaci&#243;n cr&#237;tica de la literatura"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Latour-P&#233;rez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.medin.2013.03.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2013"
                        "volumen" => "37"
                        "paginaInicial" => "409"
                        "paginaFinal" => "415"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23664006"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical practice guidelines on the management of ascites&#44; spontaneous bacterial peritonitis&#44; and hepatorenal syndrome in cirrhosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "European Association for the Study of the Liver &#40;EASL&#41;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jhep.2010.05.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Hepatol"
                        "fecha" => "2010"
                        "volumen" => "53"
                        "paginaInicial" => "397"
                        "paginaFinal" => "417"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20633946"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of adult patients with ascites due to cirrosis&#58; an update"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "B&#46;A&#46; Runyon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/hep.22853"
                      "Revista" => array:6 [
                        "tituloSerie" => "Hepatology"
                        "fecha" => "2009"
                        "volumen" => "49"
                        "paginaInicial" => "2087"
                        "paginaFinal" => "2107"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19475696"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "Technology assessment&#58; albumin&#44; non-protein colloid&#44; and crystalloid solutions"
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2000"
                        "editorial" => "University HealthSystem Consortium"
                        "editorialLocalizacion" => "Oak Brook&#44; IL"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Medimecum 2010&#46; Gu&#237;a de terapia farmacol&#243;gica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "L&#46;F&#46; Villa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:6 [
                        "edicion" => "15th ed&#46;"
                        "fecha" => "2010"
                        "paginaInicial" => "204"
                        "paginaFinal" => "205"
                        "editorial" => "ADIS"
                        "editorialLocalizacion" => "Espa&#241;a"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Colloids versus crystalloids for fluid resuscitation in critically ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Perel"
                            1 => "I&#46; Roberts"
                            2 => "K&#46; Ker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/14651858.CD000567.pub6"
                      "Revista" => array:5 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2013"
                        "volumen" => "2"
                        "paginaInicial" => "CD000567"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23450531"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "GRADE&#58; an emerging consensus on rating quality of evidence and strenght of recommendations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:7 [
                            0 => "G&#46;H&#46; Guyatt"
                            1 => "A&#46;D&#46; Oxman"
                            2 => "G&#46;E&#46; Vist"
                            3 => "R&#46; Kunz"
                            4 => "Y&#46; Falck-Ytter"
                            5 => "P&#46; Alonso-Coello"
                            6 => "GRADE Working Group"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmj.39489.470347.AD"
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2008"
                        "volumen" => "336"
                        "paginaInicial" => "924"
                        "paginaFinal" => "926"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18436948"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735727/0000003800000007/v1_201410030040/S2173572714000563/v1_201410030040/en/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/21735727/0000003800000007/v1_201410030040/S2173572714000563/v1_201410030040/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572714000563?idApp=WMIE"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Original
Results of a survey on albumin use in clinical practice in intensive care units
Resultados de una encuesta sobre la práctica clínica habitual en el empleo de albúmina en UCI
M.B. Estébanez-Montiela,
Corresponding author
belenestebanez@yahoo.es

Corresponding author.
, M. Quintana-Díazb, A. García de Lorenzo y Mateosb, R. Blancas Gomez-Caseroa, J. Acosta-Escribanoc, P. Marcos-Neirad, Transfusions and Blood Products and Metabolism and Nutrition work groups of the Spanish Society of Intensive Care and Coronary Units (Sociedad Española de Medicina Intensiva y Unidades Coronarias, SEMICYUC)
a Servicio de Medicina Intensiva, Hospital Universitario del Tajo, Aranjuez, Madrid, Spain
b Servicio de Medicina Intensiva, Hospital Universitario La Paz, Madrid, Spain
c Servicio de Medicina Intensiva, Hospital General Universitario de Alicante, Alicante, Spain
d Servicio de Medicina Intensiva, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
Read
8806
Times
was read the article
3126
Total PDF
5680
Total HTML
Share statistics
 array:23 [
  "pii" => "S2173572714000563"
  "issn" => "21735727"
  "doi" => "10.1016/j.medine.2013.08.003"
  "estado" => "S300"
  "fechaPublicacion" => "2014-10-01"
  "aid" => "625"
  "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
  "copyrightAnyo" => "2013"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Med Intensiva. 2014;38:403-12"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 3040
    "formatos" => array:3 [
      "EPUB" => 180
      "HTML" => 2116
      "PDF" => 744
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0210569113001861"
      "issn" => "02105691"
      "doi" => "10.1016/j.medin.2013.08.005"
      "estado" => "S300"
      "fechaPublicacion" => "2014-10-01"
      "aid" => "625"
      "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
      "documento" => "article"
      "crossmark" => 0
      "subdocumento" => "fla"
      "cita" => "Med Intensiva. 2014;38:403-12"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 3851
        "formatos" => array:3 [
          "EPUB" => 152
          "HTML" => 2829
          "PDF" => 870
        ]
      ]
      "es" => array:12 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
        "titulo" => "Resultados de una encuesta sobre la pr&#225;ctica cl&#237;nica habitual en el empleo de alb&#250;mina en UCI"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "403"
            "paginaFinal" => "412"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Results of a survey on albumin use in clinical practice in intensive care units"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "M&#46;B&#46; Est&#233;banez-Montiel, M&#46; Quintana-D&#237;az, A&#46; Garc&#237;a de Lorenzo y Mateos, R&#46; Blancas Gomez-Casero, J&#46; Acosta-Escribano, P&#46; Marcos-Neira"
            "autores" => array:7 [
              0 => array:2 [
                "nombre" => "M&#46;B&#46;"
                "apellidos" => "Est&#233;banez-Montiel"
              ]
              1 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Quintana-D&#237;az"
              ]
              2 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Garc&#237;a de Lorenzo y Mateos"
              ]
              3 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Blancas Gomez-Casero"
              ]
              4 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Acosta-Escribano"
              ]
              5 => array:2 [
                "nombre" => "P&#46;"
                "apellidos" => "Marcos-Neira"
              ]
              6 => array:1 [
                "colaborador" => "grupos de Trabajo de Transfusiones y Hemoderivados&#44; y de Metabolismo y Nutrici&#243;n de la Sociedad Espa&#241;ola de Medicina Intensiva y Unidades Coronarias &#40;SEMICYUC&#41;"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173572714000563"
          "doi" => "10.1016/j.medine.2013.08.003"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572714000563?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569113001861?idApp=WMIE"
      "url" => "/02105691/0000003800000007/v1_201409200306/S0210569113001861/v1_201409200306/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2173572714000551"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2013.07.007"
    "estado" => "S300"
    "fechaPublicacion" => "2014-10-01"
    "aid" => "610"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Med Intensiva. 2014;38:430-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2633
      "formatos" => array:3 [
        "EPUB" => 164
        "HTML" => 1740
        "PDF" => 729
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
      "titulo" => "Morbimortality associated to acute kidney injury in patients admitted to pediatric intensive care units"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "430"
          "paginaFinal" => "437"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Morbimortalidad asociada al da&#241;o renal agudo en pacientes ingresados en unidades de cuidados intensivos pedi&#225;tricos"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46;C&#46; G&#243;mez Polo, A&#46;J&#46; Alcaraz Romero, M&#46;A&#46; Gil-Ru&#237;z Gil-Esparza, J&#46; L&#243;pez-Herce Cid, M&#46; Garc&#237;a San Prudencio, S&#46;N&#46; Fern&#225;ndez Lafever, &#193;&#46; Carrillo &#193;lvarez"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "J&#46;C&#46;"
              "apellidos" => "G&#243;mez Polo"
            ]
            1 => array:2 [
              "nombre" => "A&#46;J&#46;"
              "apellidos" => "Alcaraz Romero"
            ]
            2 => array:2 [
              "nombre" => "M&#46;A&#46;"
              "apellidos" => "Gil-Ru&#237;z Gil-Esparza"
            ]
            3 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "L&#243;pez-Herce Cid"
            ]
            4 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Garc&#237;a San Prudencio"
            ]
            5 => array:2 [
              "nombre" => "S&#46;N&#46;"
              "apellidos" => "Fern&#225;ndez Lafever"
            ]
            6 => array:2 [
              "nombre" => "&#193;&#46;"
              "apellidos" => "Carrillo &#193;lvarez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0210569113001575"
        "doi" => "10.1016/j.medin.2013.07.002"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569113001575?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572714000551?idApp=WMIE"
    "url" => "/21735727/0000003800000007/v1_201410030040/S2173572714000551/v1_201410030040/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
    "titulo" => "Results of a survey on albumin use in clinical practice in intensive care units"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "403"
        "paginaFinal" => "412"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "M&#46;B&#46; Est&#233;banez-Montiel, M&#46; Quintana-D&#237;az, A&#46; Garc&#237;a de Lorenzo y Mateos, R&#46; Blancas Gomez-Casero, J&#46; Acosta-Escribano, P&#46; Marcos-Neira"
        "autores" => array:7 [
          0 => array:4 [
            "nombre" => "M&#46;B&#46;"
            "apellidos" => "Est&#233;banez-Montiel"
            "email" => array:1 [
              0 => "belenestebanez&#64;yahoo&#46;es"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Quintana-D&#237;az"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Garc&#237;a de Lorenzo y Mateos"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "R&#46;"
            "apellidos" => "Blancas Gomez-Casero"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Acosta-Escribano"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "P&#46;"
            "apellidos" => "Marcos-Neira"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          6 => array:1 [
            "colaborador" => "Transfusions and Blood Products and Metabolism and Nutrition work groups of the Spanish Society of Intensive Care and Coronary Units &#40;Sociedad Espa&#241;ola de Medicina Intensiva y Unidades Coronarias&#44; SEMICYUC&#41;"
          ]
        ]
        "afiliaciones" => array:4 [
          0 => array:3 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Hospital Universitario del Tajo&#44; Aranjuez&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Hospital Universitario La Paz&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Hospital General Universitario de Alicante&#44; Alicante&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Hospital Universitari Germans Trias i Pujol&#44; Badalona&#44; Barcelona&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Resultados de una encuesta sobre la pr&#225;ctica cl&#237;nica habitual en el empleo de alb&#250;mina en UCI"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Human albumin solutions are obtained from healthy donor plasma after pasteurization at 60<span class="elsevierStyleHsp" style=""></span>&#176;<span class="elsevierStyleSmallCaps">C</span> for 10<span class="elsevierStyleHsp" style=""></span>h&#44; and are used in a broad range of clinical and surgical illnesses&#44; though only some of their indications are authorized&#46; In other cases&#44; the use of albumin solutions must be decided on an individualized basis&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">1&#8211;14</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Although many studies have examined the effects of albumin solutions upon mortality in critical patients&#44; the conclusions have been contradictory<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">1</span></a>&#46; A metaanalysis carried out in 1998 with 30 randomized studies&#44; and two Cochrane reviews&#44;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a> suggested the use of albumin to be associated to increased mortality among critical patients&#46; Posteriorly&#44; another metaanalysis published in the year 2001&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> as well as more recent studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#8211;11</span></a> have failed to confirm such an increase in mortality&#44; except in patients with severe traumatic brain injury &#40;TBI&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> Furthermore&#44; the antioxidant actions of albumin and its effects upon maintenance of the plasma redox state must be taken into account for the adequate designing of future clinical studies&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Albumin solutions are more expensive than other colloids and crystalloids&#46; In addition&#44; although such solutions are usually well tolerated&#44; they are not without risks&#46; In effect&#44; albumin solutions can cause allergic reactions&#44; and very rapid infusion can induce sudden hypotension and&#44; in some cases&#44; heart failure&#8211;particularly when used at high concentrations&#46; Moreover&#44; although albumin solutions are blood products that are considered to be safe in terms of the transmission of infections&#44; there are doubts regarding the possibility of prion transmission through such solutions&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The limited availability of albumin solutions&#44; the risk of adverse effects&#44; and their high cost mean that such solutions must be used only in situations where they are known to be effective&#46; However&#44; the level of evidence on which the recommendations are based is limited&#44; and this is probably reflected in daily clinical practice by a broad range of interventions in which such solutions are used among critical care professionals&#46; With the purpose of assessing the clinical practice in Intensive Care Units &#40;ICUs&#41;&#44; the Transfusions and Blood Products and Metabolism and Nutrition work groups of the Spanish Society of Intensive Care and Coronary Units &#40;<span class="elsevierStyleItalic">Sociedad Espa&#241;ola de Medicina Intensiva y Unidades Coronarias</span>&#44; SEMICYUC&#41; have conducted a survey to evaluate the knowledge and behaviors referred to the use of albumin solutions in ICUs&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Patients and methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">A survey was developed on the use of albumin solutions in critical patients&#46; The Transfusions and Blood Products and Metabolism and Nutrition work groups of the SEMICYUC designed the questionnaire in 2012&#44; and invited Spanish and South American ICUs belonging to both public and private centers to participate via e-mail&#46; The professionals who received the questionnaire were personal contacts of the authors&#44; no preference being assigned to members of the work groups of the SEMICYUC&#46; Within each ICU&#44; only a critical care professional answered the questionnaire&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Fifty-seven ICUs were invited&#44; and all agreed to answer the questionnaire &#40;<a class="elsevierStyleCrossRef" href="#sec0080">Appendix A</a>&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The submitted questionnaire and results obtained are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; The questionnaire consisted of 35 questions&#44; most with multiple and closed answers&#44; and some with open answers&#46; The questions were grouped into different sections covering data referred to the responders and their work centers&#44; albumin use in different disease conditions&#59; and aspects referred to clinical practice&#47;evidence&#46; The aim of the questionnaire was to record the following aspects&#58; general characteristics of the ICU and of the professionals &#40;specialty&#44; years of experience&#44; and work setting&#58; type of hospital center&#44; number of hospital and ICU beds&#44; and annual admissions to the ICU&#41;&#44; usual clinical practice referred to the use of albumin solutions in different disease conditions &#40;nutritional-metabolic&#44; hypovolemia&#44; septic shock&#47;sepsis&#44; and hepatorenal disorders&#41;&#44; degree of knowledge of the available scientific evidence&#44; type of albumin solutions used&#44; and cost&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">The survey was carried out before the publication of the latest update on the Surviving Sepsis Campaign&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The data are expressed as frequencies and percentages in the case of qualitative variables&#44; and as means and standard deviations in the case of quantitative variables&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall">A total of 57 questionnaires from 54 Spanish ICUs and three South American ICUs &#40;Brazil&#44; Chile and Venezuela&#41; were analyzed&#46; All the invited ICUs answered the questionnaire&#46; In turn&#44; all the items of the questionnaire were answered&#44; except three questionnaires that failed to answer the section referred to clinical practice&#47;evidence&#44; and one questionnaire that failed to answer the sections referred to hypovolemia and sepsis&#47;septic shock&#46;</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Data referred to the professional</span><p id="par0055" class="elsevierStylePara elsevierViewall">The first part of the questionnaire explored data referred to the professionals and their working institutions&#46; Most of those interviewed were intensivists &#40;96&#46;5&#37;&#41; and mostly specialists &#40;96&#46;5&#37;&#44; of which 21&#46;1&#37; were Section Chiefs or Heads of Department&#41;&#44; with an average of 15 years of experience&#46; Only two residents in Intensive Care Medicine participated in the study&#46; In 98&#46;2&#37; of the hospital centers&#44; the intensivists were in charge of critical patient care&#46;</p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Data referred to the hospital center</span><p id="par0060" class="elsevierStylePara elsevierViewall">Most of the participating hospitals were secondary &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>23&#59; 40&#46;4&#37;&#41; or tertiary centers &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>26&#44; 45&#46;6&#37;&#41;&#44; and almost all &#40;91&#46;2&#37;&#41; registered more than 300 ICU admissions a year&#46; The mean number of beds in the ICU was 18&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#44; with an average of 500&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>349&#46;5 hospital beds&#46; In over one-half of the cases &#40;54&#46;4&#37;&#41;&#44; these data came from documented reliable sources&#44; while in 45&#46;6&#37; of the cases they represented estimates by the responders&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Questionnaire</span><p id="par0065" class="elsevierStylePara elsevierViewall">The answers to the questionnaire regarding albumin use are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Most of the professionals used albumin solutions either sporadically or not at all in the critical patient &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>55&#44; 96&#46;5&#37;&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">&#8220;Nutritional-metabolic&#8221; section</span><p id="par0070" class="elsevierStylePara elsevierViewall">With regard to the different diseases&#44; the use of albumin solutions in critical patients with protein denutrition was either sporadic or inexistent in 98&#46;2&#37; of the cases &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>56&#41;&#46; In the patients with hypoalbuminemia&#44; the use of albumin was likewise scarce or inexistent in most of the cases &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>54&#44; 94&#46;7&#37;&#41;&#46; Some professionals administered albumin when albuminemia was found to be within the following ranges&#58; 2&#8211;2&#46;5<span class="elsevierStyleHsp" style=""></span>g&#47;dl &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5 8&#46;8&#37;&#41;&#59; 1&#46;5&#8211;2<span class="elsevierStyleHsp" style=""></span>g&#47;dl &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#44; 21&#46;1&#37;&#41;&#59; and 1&#8211;1&#46;5<span class="elsevierStyleHsp" style=""></span>g&#47;dl &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#44; 10&#46;5&#37;&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Only three physicians used albumin solutions with nutrition&#58; two of them with parenteral nutrition and the other with both types of artificial nutrition &#40;enteral and parenteral&#41;&#46; Of these professionals&#44; only one occasionally used albumin solutions with insulin with the purpose of ensuring greater insulin fixation&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">&#8220;Hypovolemia&#47;hypovolemic shock&#8221; section</span><p id="par0080" class="elsevierStylePara elsevierViewall">In this section&#44; 49 responders &#40;86&#37;&#41; claimed to never or almost never use albumin for volume replacement or expansion&#44; not even in cases of hypovolemic shock&#46; Of the 7 responders who often or sometimes used albumin for volume replacement in the critical patient with hypovolemia&#47;hypovolemic shock&#44; the volume of albumin commonly administered was &#60;200<span class="elsevierStyleHsp" style=""></span>ml in two questionnaires &#40;3&#46;5&#37;&#41;&#44; 200&#8211;400<span class="elsevierStyleHsp" style=""></span>ml in four &#40;7&#37;&#41;&#44; and 800&#8211;1000<span class="elsevierStyleHsp" style=""></span>ml according to one questionnaire &#40;1&#46;8&#37;&#41;&#46; The concentration of the administered albumin solutions was 5&#37; in two questionnaires &#40;3&#46;5&#37;&#41; and 20&#37; in 6 &#40;10&#46;5&#37;&#41;&#46; The total albumin dose usually administered over 24<span class="elsevierStyleHsp" style=""></span>h to patients with hypovolemia&#47;hypovolemic shock was &#60;50<span class="elsevierStyleHsp" style=""></span>g in two questionnaires &#40;3&#46;5&#37;&#41;&#44; 50&#8211;100<span class="elsevierStyleHsp" style=""></span>g in two &#40;3&#46;5&#37;&#41;&#44; 100&#8211;200<span class="elsevierStyleHsp" style=""></span>g in two &#40;3&#46;5&#37;&#41;&#44; and &#62;200<span class="elsevierStyleHsp" style=""></span>g according to one questionnaire &#40;1&#46;8&#37;&#41;&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">&#8220;Sepsis&#47;septic shock&#8221; section</span><p id="par0085" class="elsevierStylePara elsevierViewall">Albumin solutions were never or almost never used in sepsis&#47;septic shock according to 49 responders &#40;86&#37;&#41;&#46; Only 7 physicians &#40;12&#46;3&#37;&#41; used albumin solutions occasionally or often in such situations &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; In these cases&#44; the volume administered was usually &#60;200<span class="elsevierStyleHsp" style=""></span>ml according to three questionnaires &#40;5&#46;3&#37;&#41;&#44; 200&#8211;400<span class="elsevierStyleHsp" style=""></span>ml in three &#40;5&#46;3&#37;&#41;&#44; and 400&#8211;600<span class="elsevierStyleHsp" style=""></span>ml in one questionnaire &#40;1&#46;8&#37;&#41;&#46; The concentration of the albumin solutions was 5&#37; according to one questionnaire &#40;1&#46;8&#37;&#41; and 20&#37; in 6 &#40;10&#46;5&#37;&#41;&#46; The total albumin dose usually administered by these professionals over 24<span class="elsevierStyleHsp" style=""></span>h in cases of sepsis&#47;septic shock was &#60;50<span class="elsevierStyleHsp" style=""></span>g according to one questionnaire &#40;1&#46;8&#37;&#41;&#44; 50&#8211;100<span class="elsevierStyleHsp" style=""></span>g in four questionnaires &#40;7&#37;&#41;&#44; 100&#8211;200<span class="elsevierStyleHsp" style=""></span>g in one &#40;1&#46;8&#37;&#41;&#44; and &#62;200<span class="elsevierStyleHsp" style=""></span>g in one questionnaire &#40;1&#46;8&#37;&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">&#8220;Hepatorenal&#8221; section</span><p id="par0090" class="elsevierStylePara elsevierViewall">Fifty ICUs &#40;87&#46;7&#37;&#41; used albumin in critical patients with liver disease and hypoalbuminemia&#46; Fifty-six responders &#40;98&#46;2&#37;&#41; administered albumin after evacuating paracentesis&#44; while 52 &#40;91&#46;2&#37;&#41; did so in patients with hepatorenal syndrome&#46; The aspects most taken into account by the professionals in administering albumin to critical patients with liver disease were&#58; volume of ascitic fluid evacuated at paracentesis &#40;51 responders&#44; 89&#46;5&#37;&#41;&#44; serum albumin &#40;29 responders&#44; 50&#46;9&#37;&#41; and diuresis &#40;28 responders&#44; 49&#46;1&#37;&#41;&#46; Twenty-eight physicians &#40;49&#46;1&#37;&#41; administered albumin to critical patients with anasarca before the administration of furosemide&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">&#8220;Other uses&#8221; section</span><p id="par0095" class="elsevierStylePara elsevierViewall">This section explored the use of plasmapheresis in the different hospital centers&#46; Forty-two centers &#40;73&#46;7&#37;&#41; claimed to use the technique&#46; One of the responders did not know whether plasmapheresis was performed with albumin in his center&#46; In the rest of the cases&#44; albumin solutions were used in the plasmapheresis sessions at least occasionally in 57&#46;9&#37; of the cases &#40;33 centers&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Among the indications of albumin not reflected in the questionnaire&#44; the options cited by the responders were liver dialysis with MARS<span class="elsevierStyleSup">&#174;</span> &#40;molecular adsorbent recirculating system&#41; in four questionnaires &#40;7&#37;&#41;&#44; oligoanuric renal failure with severe hypoalbuminemia &#40;&#60;1&#46;5<span class="elsevierStyleHsp" style=""></span>g&#47;dl&#41; in one &#40;1&#46;8&#37;&#41;&#44; non-continuous hemodialysis with hypotensive episodes and the intent to achieve negative water balance in one questionnaire &#40;1&#46;8&#37;&#41;&#44; hypoproteinemia in one &#40;1&#46;8&#37;&#41;&#44; and resuscitation in major burn victims in two questionnaires &#40;3&#44;5&#37;&#41;&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">&#8220;Clinical practice&#47;evidence&#8221; section</span><p id="par0105" class="elsevierStylePara elsevierViewall">This section was answered by 54 responders&#46; A large percentage of the professionals &#40;77&#46;2&#37;&#41; claimed to know the available scientific evidence regarding the use of albumin in critical patients without liver disease&#46; Nevertheless&#44; 3&#46;5&#37; preferred to rely on their own professional experience to establish the indication&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">On the other hand&#44; 57&#46;9&#37; of the responders considered that the use of albumin solutions never or almost never has a positive impact upon critical patients without liver disease&#44; while 31&#46;6&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>18&#41; agreed that albumin use always or generally could have a negative impact upon such patients&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">The majority of the professionals &#40;82&#46;5&#37;&#41; claimed to know the available scientific evidence regarding the use of albumin in critical patients with liver disease&#46; Three physicians preferred to rely on their own professional experience to establish the indication&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The prevalent opinion &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>49&#44; 86&#37;&#41; was that the use of albumin in patients with liver disease could exert a beneficial effect upon the clinical course&#44; and few considered that albumin in general could exert a negative effect &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#44; 10&#46;5&#37;&#41;&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">The most frequently used albumin vial volume was 50<span class="elsevierStyleHsp" style=""></span>ml according to 48 responders &#40;84&#46;2&#37;&#41;&#44; while the most commonly administered concentration was 20&#37; according to 49 responders &#40;86&#37;&#41;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Most of the responders were unaware of the price of the albumin solutions &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>35&#44; 61&#46;4&#37;&#41;&#44; and only 15&#46;8&#37; correctly estimated the price of a 50-ml vial of human albumin at a concentration of 20&#37;&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Almost one-half of the responders knew of no substitute for albumin solutions&#46; The most frequently identified substitutes were colloids &#40;43&#46;9&#37; of the responders&#41;&#46;</p></span></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Discussion</span><p id="par0140" class="elsevierStylePara elsevierViewall">The number of completed questionnaires constitutes a large sample reflecting routine practice in Spain&#44; though it might not be fully representative of the true situation&#44; since the ICUs were not selected on a random basis&#46; Nevertheless&#44; the answers were very homogeneous in practically all the analyzed areas&#44; and this in turn suggests that the survey effectively reflects routine practice regarding the use of albumin solutions&#46; The South American sample is of course too small to allow us to draw such conclusions&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">It would be interesting to repeat this study some years after its publication&#44; with a larger number of ICUs&#44; in order to determine whether the recent studies<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17&#44;18</span></a> on the utilization of albumin in septic patients lead to changes in the way in which albumin is used&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">The questionnaires were mainly answered by experienced intensivists working in medium to large centers and with a considerable number of ICU admissions each year&#46; In this setting&#44; albumin solutions were used sporadically or were not used in critical patients&#46; This observation persisted in the different sections of the questionnaire&#44; with the sole exception of the hepatorenal section&#46; Thus&#44; albumin was little used or not used at all in denutrition&#44; hypoalbuminemia&#44; hypovolemia and sepsis&#47;septic shock&#46; This is consistent with the general recommendations on albumin use&#46; <a class="elsevierStyleCrossRef" href="#tbl0040">Table 2</a> shows the level of evidence referred to the use of albumin solutions in the different sections of the questionnaire&#46;</p><elsevierMultimedia ident="tbl0040"></elsevierMultimedia><p id="par0155" class="elsevierStylePara elsevierViewall">The recently published consensus document of the European Society of Intensive Care on the use of colloids in the critical patient contemplates the possibility of administering albumin solutions in septic patients&#44; though their efficacy has not been firmly established&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> The more recent review of the management guides of the Surviving Sepsis Campaign recommend the administration of albumin in patients with septic shock who require large amounts of crystalloids&#44; with level of evidence 2C according to the Grading of Recommendations Assessment&#44; Development and Evaluation &#40;GRADE&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> This document has been published after the present survey&#44; and therefore could not be taken into account by the responders of the questionnaire&#46; In any case&#44; the evidence on the effectiveness of albumin in sepsis lacks the quality needed to allow its recommendation in severe sepsis&#47;septic shock&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">The indications of albumin are supported by a greater level of evidence in the case of hepatorenal disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;21</span></a> This is also reflected by the findings of our study&#46; In fact&#44; most of the responders used albumin solutions in patients with liver disease and hypoalbuminemia&#44; following evacuating paracentesis or in hepatorenal syndrome&#46; In deciding to use albumin&#44; the professionals mainly considered albuminemia&#44; diuresis and the volume of ascitic fluid collected at paracentesis&#46; Indeed&#44; the volume of ascitic fluid collected at paracentesis establishes the indication of albumin administration&#46; Cirrhotic patients with spontaneous bacterial peritonitis or type I hepatorenal syndrome could also benefit from the administration of albumin solutions&#44; though there are no other indications for albumin use in these patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;20</span></a> However&#44; although there is no scientific evidence warranting the indication of albumin associated to furosemide in patients with anasarca&#44; the results of our study show that almost one-half of the responders used this combination&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Plasmapheresis was available in a large percentage of the centers in our study&#44; and in over one-half of the cases albumin solutions were used to replace the extracted plasma&#46; Based on the available evidence&#44; the use of albumin during plasmapheresis involving the extraction of over 20<span class="elsevierStyleHsp" style=""></span>ml of plasma&#47;kg body weight in a single session&#44; or 20<span class="elsevierStyleHsp" style=""></span>ml&#47;kg&#47;week in several consecutive sessions&#44; is considered adequate&#46; When the volumes are smaller&#44; the indication of albumin should be established on an individualized basis&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16&#44;22</span></a> In our survey we requested no information on the indications of plasmapheresis with albumin in relation to the needs referred to volume exchange&#46; However&#44; over 28&#37; of the responders claimed that plasmapheresis sessions were always or almost always performed with albumin&#46; We do not know whether there was precise knowledge of the technique on the part of the responders in each center&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Most of the responders considered that albumin use complies with the current recommendations referred to critical patients without liver disease&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> Furthermore&#44; most of the responders were of the opinion that albumin has no positive impact upon the patients&#44; and indeed could even have a negative effect&#46; The available literature does not offer conclusive proof that albumin reduces the mortality rate among patients with hypovolemia&#44; burns and hypoproteinemia&#44; although there is also no proof that it might increase the mortality risk&#46; Consequently&#44; the scant use of albumin in these patients is consistent with the scientific evidence&#46; The degree of dissatisfaction on the part of the professionals regarding the scientific literature supports the need to conduct well-designed studies with homogeneous populations and adequate sample sizes&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Although the studies conducted to date have not confirmed the positive or negative effect which albumin use might have&#44; in the subgroup of patients with severe traumatic brain injury &#40;TBI&#41; of the SAFE study&#44;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> the administration of albumin was associated to greater mortality than resuscitation performed with physiological saline solution &#40;OR 1&#46;8&#59; 95&#37;CI 1&#46;31&#8211;2&#46;70&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; In our survey we did not ask about the management of patients with TBI&#44; though considering the scant use of albumin in the resuscitation of critical patients&#44; similar considerations probably could also be extrapolated to severe TBI&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">In critical patients with liver disease&#44; the levels of evidence referred to albumin use are higher&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;21</span></a> This is related to the fact that in this case there are more studies with an adequate design and with more homogeneous populations&#46; In this regard&#44; our study shows that in the case of critical patients with liver disease&#44; the evidence was more widely known among the responders and guided albumin use more often&#46; The belief that at least in some cases albumin use could have a positive effect was more prevalent in the case of these patients&#44; and the belief that it might have a negative impact was less prevalent&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">The need for more studies with adequate designs&#44; the low levels of evidence referred to albumin use in most critical situations&#44; and the lack of knowledge of the effects of albumin upon mortality undoubtedly condition the habits regarding albumin use and which are still found in the routine practice of some ICUs&#44; despite the absence of adequate degrees of recommendation&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">In order to obtain more information on routine clinical practice&#44; we asked about the albumin vials commonly used in the ICUs&#46; In this respect&#44; the vials were found to contain 50<span class="elsevierStyleHsp" style=""></span>ml of albumin solution at a concentration of 5 or 20&#37;&#46; In general&#44; the available presentations and concentrations of albumin were known to the professionals&#46; Few of the responders in our study used concentrations not found on the market&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Regarding knowledge of the cost of albumin use&#44; the questionnaire asked about the price of the vials&#46; The price of a 50-ml vial containing 20&#37; albumin ranges from 37&#46;45 to 44&#46;87 euros &#40;updated prices in Medimecum 2010<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a>&#41;&#46; A large percentage of the responders did not know the cost of albumin&#44; and only 15&#46;8&#37; offered an adequate price estimate of between 30 and 50 euros&#46; The cost of the albumin solutions therefore does not seem to be particularly important in deciding to use such products&#44; since most of the professionals were unaware of the price of the vials&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Among the substitutes of albumin solutions&#44; a large percentage of the responders &#40;43&#46;9&#37;&#41; cited colloids &#40;starches&#44; dextrans and gelatins&#41; as an alternative&#46; Colloids are used in routine clinical practice mainly for resuscitation in hypovolemia &#40;absolute or relative&#41;&#44; although there is controversy regarding the type of fluid indicated in such cases&#44; and at present colloids are not considered to be better than crystalloids&#46; This is another issue requiring further clarification&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a></p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Conclusions</span><p id="par0205" class="elsevierStylePara elsevierViewall">The use of human albumin solutions is not recognized as a common practice among physicians attending critical patients&#44; except in the case of subjects with liver disease&#46; Knowledge of the available scientific evidence is reported to be widespread among these physicians&#46; In general&#44; the opinions on the use of albumin solutions are consistent with the established recommendations&#44; particularly in patients with liver disease&#44; and their utilization in the ICU is guided by the available evidence&#46; Professional experience conditions the decision to use albumin&#8211;the mentioned recommendations prevailing only among a minority of professionals&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0170">Conflicts of interest</span><p id="par0210" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:2 [
          "identificador" => "xres373973"
          "titulo" => array:8 [
            0 => "Abstract"
            1 => "Background"
            2 => "Objectives"
            3 => "Design"
            4 => "Period"
            5 => "Methods"
            6 => "Results"
            7 => "Conclusions"
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec353022"
          "titulo" => "Keywords"
        ]
        2 => array:2 [
          "identificador" => "xres373974"
          "titulo" => array:9 [
            0 => "Resumen"
            1 => "Introducci&#243;n"
            2 => "Objetivo"
            3 => "Dise&#241;o"
            4 => "Periodo"
            5 => "&#193;mbito"
            6 => "M&#233;todos"
            7 => "Resultados"
            8 => "Conclusiones"
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec353021"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Patients and methods"
        ]
        6 => array:3 [
          "identificador" => "sec0015"
          "titulo" => "Results"
          "secciones" => array:1 [
            0 => array:3 [
              "identificador" => "sec0020"
              "titulo" => "Data referred to the professional"
              "secciones" => array:8 [
                0 => array:2 [
                  "identificador" => "sec0025"
                  "titulo" => "Data referred to the hospital center"
                ]
                1 => array:2 [
                  "identificador" => "sec0030"
                  "titulo" => "Questionnaire"
                ]
                2 => array:2 [
                  "identificador" => "sec0035"
                  "titulo" => "&#8220;Nutritional-metabolic&#8221; section"
                ]
                3 => array:2 [
                  "identificador" => "sec0040"
                  "titulo" => "&#8220;Hypovolemia&#47;hypovolemic shock&#8221; section"
                ]
                4 => array:2 [
                  "identificador" => "sec0045"
                  "titulo" => "&#8220;Sepsis&#47;septic shock&#8221; section"
                ]
                5 => array:2 [
                  "identificador" => "sec0050"
                  "titulo" => "&#8220;Hepatorenal&#8221; section"
                ]
                6 => array:2 [
                  "identificador" => "sec0055"
                  "titulo" => "&#8220;Other uses&#8221; section"
                ]
                7 => array:2 [
                  "identificador" => "sec0060"
                  "titulo" => "&#8220;Clinical practice&#47;evidence&#8221; section"
                ]
              ]
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0065"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0070"
          "titulo" => "Conclusions"
        ]
        9 => array:2 [
          "identificador" => "sec0075"
          "titulo" => "Conflicts of interest"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2013-05-16"
    "fechaAceptado" => "2013-08-28"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec353022"
          "palabras" => array:4 [
            0 => "Survey"
            1 => "Albumin solutions"
            2 => "Clinical practice"
            3 => "Critically ill patient"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec353021"
          "palabras" => array:4 [
            0 => "Encuesta"
            1 => "Soluciones de alb&#250;mina"
            2 => "Pr&#225;ctica cl&#237;nica"
            3 => "Paciente cr&#237;tico"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Human albumin solutions are used in a number of disorders&#44; though their indications are not clear in all circumstances&#46; These solutions are costly&#44; and their benefit has not been established in all settings&#46; It is therefore interesting to assess the presence of albumin solutions in the daily clinical practice of critical care professionals&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0015">Objectives</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">To report the standard clinical practices and to describe the variability of albumin solutions use in critically ill patients&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0020">Design</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">A survey sent by e-mail to Spanish and South American Intensive Care Units &#40;ICUs&#41;</p> <span class="elsevierStyleSectionTitle" id="sect0025">Period</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Planning and execution were during the year 2012&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0030">Methods</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">A questionnaire comprising of 35 questions&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0035">Results</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Fifty-seven surveys were analyzed&#46; The use of albumin solutions was sporadic or negligible in critically ill patients &#40;96&#46;5&#37;&#41;&#46; The exceptions were patients with liver disease &#40;87&#46;7&#37; of the responders administered albumin to these patients&#41;&#46; A high percentage of professionals claimed to know the available scientific evidence on the use of albumin in patients with liver disease &#40;82&#46;5&#37;&#41; and in patients without liver disease &#40;77&#46;2&#37;&#41;&#46; Only 5&#46;3&#37; of the responders preferred to rely on their own experience to establish the indications of albumin use&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0040">Conclusions</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">The use of albumin solutions is infrequent in ICUs&#44; except in patients with liver disease&#46; Evidence-based knowledge on albumin use is declared to be extensive in ICUs&#46; As a rule&#44; opinions on the use of albumin solutions are based on the scientific recommendations&#44; especially in patients with liver disease&#46; Professional experience rarely prevails over the published clinical guidelines&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0050">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Las soluciones de alb&#250;mina humana se emplean en diversas enfermedades&#44; aunque su indicaci&#243;n no es clara en todas&#46; Presentan un coste elevado y su beneficio no se encuentra plenamente establecido&#46; Resulta interesante conocer cu&#225;l es la presencia de las soluciones de alb&#250;mina en la pr&#225;ctica cl&#237;nica diaria de los intensivistas&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0055">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Documentar pr&#225;cticas cl&#237;nicas habituales y describir la variabilidad de las mismas en cuanto al empleo de soluciones de alb&#250;mina en enfermos cr&#237;ticos&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0060">Dise&#241;o</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Encuesta enviada mediante correo electr&#243;nico a unidades de cuidados intensivos &#40;UCI&#41; espa&#241;olas y sudamericanas&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0065">Periodo</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Planificaci&#243;n y realizaci&#243;n durante el a&#241;o 2012&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0070">&#193;mbito</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">UCI espa&#241;olas y sudamericanas&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0075">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Cuestionario de 35 preguntas&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0080">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se han analizado 57 encuestas&#46; El empleo de las soluciones de alb&#250;mina fue espor&#225;dico o no se empleaba en el paciente cr&#237;tico &#40;96&#44;5&#37;&#41;&#46; La excepci&#243;n fueron los pacientes hepat&#243;patas &#40;un 87&#44;7&#37; de los encuestados la administraba&#41;&#46; Un elevado porcentaje declar&#243; conocer la evidencia cient&#237;fica disponible sobre el empleo de alb&#250;mina en pacientes hepat&#243;patas &#40;82&#44;5&#37;&#41; y no hepat&#243;patas &#40;77&#44;2&#37;&#41;&#46; El 5&#44;3&#37; de los encuestados prefer&#237;a basarse en su experiencia para establecer las indicaciones del empleo de alb&#250;mina&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0085">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El empleo de soluciones de alb&#250;mina no es frecuente en las UCI&#44; salvo en pacientes hepat&#243;patas&#46; Los profesionales del enfermo cr&#237;tico manifiestan tener un amplio conocimiento de la evidencia cient&#237;fica&#46; Las opiniones emitidas&#44; acerca del empleo de alb&#250;mina&#44; son acordes con las recomendaciones establecidas&#44; sobre todo&#44; en pacientes hepat&#243;patas&#46; La experiencia profesional prevalece en escasas ocasiones sobre las recomendaciones publicadas&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Est&#233;banez-Montiel MB&#44; Quintana-D&#237;az M&#44; Garc&#237;a de Lorenzo y Mateos A&#44; Blancas Gomez-Casero R&#44; Acosta-Escribano J&#44; Marcos-Neira P&#44; et al&#46; Resultados de una encuesta sobre la pr&#225;ctica cl&#237;nica habitual en el empleo de alb&#250;mina en UCI&#46; Med Intensiva&#46; 2014&#59;38&#58;403&#8211;412&#46;</p>"
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0215" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Andalusia</span>&#58; Pilar Mart&#237;nez &#40;Hospital de Puerto Real&#44; C&#225;diz&#41;&#59; Antonio Valverde &#40;Hospital Virgen de la Victoria&#44; M&#225;laga&#41;&#59; Manuel Herrera&#44; Juan Fern&#225;ndez &#40;Hospital Carlos Haya&#44; M&#225;laga&#41;&#59; Carlos Ortiz&#44; Juan Jos&#233; Egea &#40;Hospital Virgen del Roc&#237;o&#44; Sevilla&#41;&#59; Juan M&#225;rquez &#40;Hospital de la Macarena&#44; Sevilla&#41;&#46; <span class="elsevierStyleItalic">Arag&#243;n</span>&#58; Carlos Gonz&#225;lez &#40;Hospital de Barbastro&#44; Barbastro&#41;&#59; Carlos Ser&#243;n &#40;Hospital San Jorge&#44; Huesca&#41;&#46; <span class="elsevierStyleItalic">Asturias</span>&#58; Jos&#233; Antonio Gonzalo &#40;Hospital Central de Asturias&#44; Oviedo&#41;&#46; <span class="elsevierStyleItalic">Brasil</span>&#58; Val&#233;ria Abrah&#227;o &#40;Hospital Ipanema Plus&#44; R&#237;o de Janeiro&#41;&#46; <span class="elsevierStyleItalic">Castilla</span><span class="elsevierStyleBold">-</span><span class="elsevierStyleItalic">La Mancha</span>&#58; Ana Bueno &#40;Hospital General de Ciudad Real&#44; Ciudad Real&#41;&#59; Elena Gonz&#225;lez &#40;Hospital Virgen de la Luz&#44; Cuenca&#41;&#59; Miguel &#193;ngel Taberna &#40;Hospital Nuestra Se&#241;ora del Prado&#44; Talavera de la Reina&#41;&#59; Marcelino S&#225;nchez &#40;Hospital Virgen de la Salud&#44; Toledo&#41;&#59; Francisca Prieto &#40;Hospital de Santa B&#225;rbara&#44; Puertollano&#41;&#59; Jaime Serrano &#40;Hospital General La Mancha-Centro&#44; Alc&#225;zar de San Juan&#41;&#59; Sergio S&#225;ez&#44; Concepci&#243;n Garc&#237;a &#40;Hospital Provincial de la Misericordia&#44; Toledo&#41;&#46; <span class="elsevierStyleItalic">Castilla</span><span class="elsevierStyleBold">-</span><span class="elsevierStyleItalic">Le&#243;n</span>&#58; Miriam Ochoa &#40;Hospital Cl&#237;nico Universitario de Salamanca&#44; Salamanca&#41;&#59; Sopetr&#225;n Rey&#44; Mar&#237;a Jes&#250;s L&#243;pez&#44; Santiago Mac&#237;as&#44; Patricia Jimeno &#40;Hospital General de Segovia&#44; Segovia&#41;&#59; Vicente Mor&#225;n &#40;Complejo Hospitalario de Le&#243;n&#44; Le&#243;n&#41;&#59; Teresita Loreto &#40;Hospital Virgen de la Concha&#44; Zamora&#41;&#46; <span class="elsevierStyleItalic">Catalonia</span>&#58; Alberto Sanduimenge &#40;Hospital Universitari Joan <span class="elsevierStyleSmallCaps">XXIII</span>&#44; Tarragona&#41;&#59; Luis Servi&#225; &#40;Hospital Arnau de Vilanova&#44; L&#233;rida&#41;&#59; Carol Lorencia&#44; Alfonso Bonet &#40;Hospital Universitari Doctor Josep Trueta&#44; Gerona&#41;&#59; &#193;ngel Robles &#40;Hospital Vall d¿Hebron&#44; Barcelona&#41;&#59; Ferr&#225;n Roche &#40;Hospital Sant Pau&#44; Barcelona&#41;&#59; Carles Ferrer &#40;Hospital M&#250;tua de Terrasa&#44; Tarrasa&#41;&#59; Luisa Bordel &#40;Hospital Universitari Germans Trias i Pujol&#44; Badalona&#41;&#46; <span class="elsevierStyleItalic">Chile</span>&#58; Darwin Acosta &#40;Hospital Cl&#237;nico Mutual&#44; Iquique&#41;&#46; <span class="elsevierStyleItalic">Extremadura</span>&#58; Marta Montans &#40;Hospital San Pedro de Alc&#225;ntara&#44; C&#225;ceres&#41;&#46; <span class="elsevierStyleItalic">Balearic Islands</span>&#58; Carlos Ant&#243;n &#40;Hospital de Manacor&#44; Manacor&#41;&#59; Isabel Ceniceros &#40;Cl&#237;nica ISP Palmaplanas&#44; Palma de Mallorca&#41;&#46; <span class="elsevierStyleItalic">La Rioja</span>&#58; Mar&#237;a Mac&#237;as &#40;Hospital de San Pedro&#44; Logro&#241;o&#41;&#46; <span class="elsevierStyleItalic">Madrid</span>&#58; Blanca L&#243;pez Matamala &#40;Hospital Universitario del Tajo&#44; Aranjuez&#41;&#59; Fernando Monasterio&#44; Manuel S&#225;nchez &#40;Hospital Universitario de la Princesa&#44; Madrid&#41;&#59; Amalia de la G&#225;ndara &#40;Hospital Infanta Leonor&#44; Madrid&#41;&#59; Vicente G&#243;mez &#40;Hospital Moncloa&#44; Madrid&#41;&#59; Juan Carlos Montejo &#40;Hospital 12 de Octubre&#44; Madrid&#41;&#59; Antonio Blesa &#40;Hospital Cl&#237;nico de San Carlos&#44; Madrid&#41;&#59; Jos&#233; &#193;ngel Lorente &#40;Hospital Universitario de Getafe&#44; Getafe&#41;&#59; Clara Vaquerizo &#40;Hospital Fundaci&#243;n Fuenlabrada&#44; Fuenlabrada&#41;&#59; Pedro Gald&#243;s &#40;Hospital Universitario Puerta de Hierro&#44; Majadahonda&#41;&#59; Patricia Albert &#40;Hospital Universitarios del Sureste&#44; Arganda&#41;&#59; Alberto Hern&#225;ndez &#40;Hospital Universitario Fundaci&#243;n Alcorc&#243;n&#44; Alcorc&#243;n&#41;&#59; &#193;ngela Algaba &#40;Hospital Universitario de Torrej&#243;n&#44; Torrej&#243;n de Ardoz&#41;&#59; Jorge L&#243;pez &#40;Hospital Severo Ochoa&#44; Legan&#233;s&#41;&#46; <span class="elsevierStyleItalic">Murcia</span>&#58; Francisco Garc&#237;a &#40;Hospital General Universitario Los Arcos del Mar Menor&#44; San Javier&#41;&#59; Carmen S&#225;nchez &#40;Hospital General Universitario Reina Sof&#237;a&#44; Murcia&#41;&#46; <span class="elsevierStyleItalic">Navarre</span>&#58; Laura Macaya &#40;Hospital General de Navarra&#44; Pamplona&#41;&#46; <span class="elsevierStyleItalic">Basque Country</span>&#58; Mar&#237;a Mercedes Zabarte &#40;Hospital Donostia&#44; San Sebasti&#225;n&#41;&#46; <span class="elsevierStyleItalic">Valencia</span>&#58; Manuel Cervera &#40;Hospital Arnau de Vilanova&#44; Valencia&#41;&#59; Alfonso Mesejo &#40;Hospital Cl&#237;nico&#44; Valencia&#41;&#59; Miguel &#193;ngel Garc&#237;a &#40;Hospital de Torrevieja&#44; Torrevieja&#41;&#59; Jos&#233; Antonio Acosta &#40;Hospital General de Alicante&#44; Alicante&#41;&#59; Bego&#241;a Balerdi&#44; Remedios Clemente &#40;Hospital La Fe&#44; Valencia&#41;&#59; Lid&#243;n Mateu &#40;Hospital General de Castell&#243;n&#44; Castell&#243;n&#41;&#46; <span class="elsevierStyleItalic">Venezuela</span>&#58; Tully Baptista &#40;Hospital Universitario&#44; Caracas&#41;&#46;</p>"
            "etiqueta" => "Appendix A"
            "titulo" => "List of collaborators in the responding centers"
            "identificador" => "sec0080"
          ]
        ]
      ]
    ]
    "multimedia" => array:2 [
      0 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Ig&#58; immunoglobulins&#59; EN&#58; enteral nutrition&#59; PN&#58; parenteral nutrition&#59; FFP&#58; fresh frozen plasma&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Questionnaire</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Questions</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Answers</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">&#37;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;1&#41; Do you regularly use albumin solutions in the treatment of critical patients&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">03&#46;549&#46;147&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Nutritional-metabolic</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;2&#41; Do you regularly use albumin solutions in the case of critical patients with protein denutrition&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">01&#46;819&#46;378&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;3&#41; Do you regularly use albumin solutions in the case of critical patients with hypoalbuminemia&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">05&#46;335&#46;159&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;4&#41; If you use albumin solutions in patients with hypoalbuminemia&#44; from what serum albumin concentration do you decide to administer them&#63; &#40;g&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#8211;3&#46;52&#46;5&#8211;32&#8211;2&#46;51&#46;5&#8211;21&#8211;1&#46;5&#60;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">008&#46;821&#46;110&#46;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;5&#41; Do you administer albumin with critical patient nutrition&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">005&#46;394&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;6&#41; If you administer albumin with nutrition&#44; what types of nutrition do you use&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enteral nutritionParenteral nutritionBoth&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">03&#46;51&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;7&#41; If you use albumin solutions in these cases&#44; do you do so added to insulin for improved fixation&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0003&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hypovolemia&#47;hypovolemic shock</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;8&#41; Do you regularly use albumin solutions in the case of critical patients requiring volume replacement&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">01&#46;810&#46;586&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;9&#41; Do you regularly use albumin solutions in the case of critical patients with hypovolemic shock&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">01&#46;810&#46;586&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;10&#41; If you use albumin solutions in hypovolemia&#47;hypovolemic shock&#44; the volume you usually administer is &#40;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;200200&#8211;400400&#8211;600600&#8211;800800&#8211;1000&#62;1000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;57001&#46;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;11&#41; At what concentration do you administer albumin in these cases&#63; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52025Diluted&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;5 10&#46;500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;12&#41; The total albumin dose over 24<span class="elsevierStyleHsp" style=""></span>h which you usually use in patients with hypovolemia&#47;hypovolemic shock is &#40;g&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8804;5050&#8211;100100&#8211;200&#62;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;53&#46;5 3&#46;51&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Sepsis&#47;septic shock</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;13&#41; Do you regularly use albumin solutions in the case of critical patients with sepsis&#47;septic shock&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">01&#46;810&#46;586&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;14&#41; If you use albumin solutions in sepsis&#47;septic shock&#44; the volume you usually administer is &#40;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;200200&#8211;400400&#8211;600600&#8211;800800&#8211;1000&#62;1000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;35&#46;31&#46;8000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;15&#41; At what concentration do you administer albumin in these cases&#63; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52025Diluted&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;810&#46;500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;16&#41; The total albumin dose over 24<span class="elsevierStyleHsp" style=""></span>h which you usually use in patients with sepsis&#47;septic shock is &#40;g&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8804;5050&#8211;100100&#8211;200&#62;200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;871&#46;81&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hepatorenal</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;17&#41; Do you regularly use albumin solutions in the case of critical patients with liver disease and hypoalbuminemia&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;521&#46;156&#46;112&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;18&#41; Do you regularly use albumin solutions in the case of critical patients with liver disease subjected to evacuating paracentesis&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#46;631&#46;6141&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;19&#41; Do you regularly use albumin solutions in the case of critical patients with liver disease and hepatorenal syndrome&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;324&#46;640&#46;48&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;20&#41; You use albumin solutions in patients with liver disease considering the following parameters&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Serum albuminTotal blood proteinsAge and basal conditionPatient nutritional conditionVolemiaDiuresisVolume of ascitic fluid at paracentesisOthers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#46;910&#46;512&#46;31428&#46;149&#46;189&#46;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;21&#41; Do you regularly use albumin solutions in the case of critical patients with anasarca before the administration of furosemide&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;3736&#46;850&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Other uses</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;22&#41; Is plasmapheresis performed in your center&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YesNo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#46;726&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;23&#41; If your center performs plasmapheresis&#44; is replacement made with albumin solutions&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;1722&#46;814&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;24&#41; If you use albumin solutions in relation to other indications not mentioned in this questionnaire&#44; please specify which indications&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MARS<span class="elsevierStyleSup">&#174;</span>Resuscitation in major burnsOligoanuric renal failure with severe hypoalbuminemia &#40;&#60;1&#46;5<span class="elsevierStyleHsp" style=""></span>g&#47;dl&#41;Non-continuous hemodialysis with hypotensive episodes and the intent to achieve negative water balanceHypoproteinemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#46;51&#46;81&#46;81&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Clinical practice&#47;evidence</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;25&#41; Do you know the available scientific evidence referred to the use of albumin solutions in critical patients without liver disease&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; it is clear in this respectYes&#44; but it does not clarify the usual doubtsYes&#44; but I prefer to rely on my own experienceNo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;347&#46;43&#46;517&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;26&#41; Do you think the use of albumin solutions can have a positive effect upon the prognosis of critical patients without liver disease&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">01&#46;8035&#46;157&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;27&#41; The routine use of albumin solutions can have a negative impact upon critical patients without liver disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">I fully agreeI generally agreeI neither agree nor disagreeI sometimes agreeI rarely agreeI disagree&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;319&#46;329&#46;821&#46;11&#46;810&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;28&#41; Do you know the available scientific evidence referred to the use of albumin solutions in critical patients with liver disease&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; it is clear in this respectYes&#44; but it does not clarify the usual doubtsYes&#44; but I prefer to rely on my own experienceNo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&#46;933&#46;35&#46;312&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;29&#41; Do you think the use of albumin solutions can have a positive effect upon the prognosis of critical patients with liver disease&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#44; always or almost alwaysYes&#44; oftenYes&#44; sometimesNever or almost never&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;817&#46;559&#46;68&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;30&#41; The routine use of albumin solutions can have a negative impact upon critical patients with liver disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">I fully agreeI generally agreeI neither agree nor disagreeI sometimes agreeI rarely agreeI disagree&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">010&#46;510&#46;533&#46;312&#46;328&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;31&#41; If you administer albumin solutions&#44; the volume of the vials you use is &#40;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1050100250500Others&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">084&#46;275&#46;31&#46;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;32&#41; If you administer albumin solutions&#44; the albumin concentration you usually use is &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35152025Diluted&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;810&#46;51&#46;8863&#46;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;33&#41; Do you know the price of the albumin solutions&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YesNo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#46;361&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;34&#41; If you do not know the price of the albumin solutions&#44; you estimate that a vial containing 50<span class="elsevierStyleHsp" style=""></span>ml of albumin 20&#37; costs &#40;&#8364;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8804;1010&#8211;3030&#8211;50&#62;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;85&#46;315&#46;831&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;35&#41; Do you know any substitutes of albumin solutions&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&#46; Which&#63;&#8211; Colloids&#8211; FFP&#8211; Ig&#8211; EN and PNNo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#46;443&#46;98&#46;81&#46;81&#46;847&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab565991.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Full-submitted questionnaire and answers received&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl0040"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">GRADE system<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a>&#58; Evaluates the strength of recommendation as A &#40;strong&#41; or B &#40;weak&#41;&#44; and the quality of evidence as high &#40;it is unlikely for the results of new studies to modify confidence in estimation of the effect&#41;&#44; moderate &#40;estimation of the effect is probably close to the real effect&#44; but there might be substantial differences&#41;&#44; low &#40;new studies are likely to modify confidence in estimation of the effect and its magnitude&#41;&#44; or very low &#40;any estimation of effect is very uncertain&#41;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Disease condition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Levels of evidence &#40;GRADE&#41;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Isolated hypoalbuminemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No evidence<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hypovolemia&#47;hypovolemic shock&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No evidence<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6&#44;24</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sepsis&#47;septic shock&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2B<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a>&#8211;2C<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Paracentesis in large volume ascites in cirrhotic patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1A<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Type I hepatorenal syndrome &#40;with terlipressin&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1A<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Plasmapheresis with large volume plasma exchange&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Consensus exists<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab565992.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Levels of evidence referred to the use of albumin solutions in the different sections of the questionnaire&#44; according to the available recommendations&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:25 [
            0 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Albumin Reviewers&#46; Soluci&#243;n de alb&#250;mina humana para la reanimaci&#243;n y la expansi&#243;n de volumen en pacientes cr&#237;ticos &#40;Revisi&#243;n Cochrane traducida&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Alderson"
                            1 => "F&#46; Bunn"
                            2 => "C&#46; Lefebvre"
                            3 => "A&#46; Li Wan Po"
                            4 => "L&#46; Li"
                            5 => "I&#46; Roberts"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "titulo" => "La Biblioteca Cochrane Plus&#44; 2008 N&#250;mero 4"
                        "fecha" => "2008"
                        "editorial" => "Update Software Ltd&#46;"
                        "editorialLocalizacion" => "Oxford"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Human albumin administration in critically ill patients&#58; systematic review of randomised controlled trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Cochrane Injuries Group Albumin Reviewers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "1998"
                        "volumen" => "317"
                        "paginaInicial" => "235"
                        "paginaFinal" => "240"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9677209"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Human albumin solution for resuscitation and volume expansion in critically ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "F&#46; Bunn"
                            1 => "C&#46; Lefebvre"
                            2 => "A&#46; Li Wan Po"
                            3 => "L&#46; Li"
                            4 => "I&#46; Roberts"
                            5 => "G&#46; Schierhout"
                            6 => "The Albumin Reviewers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/14651858.CD001208"
                      "Revista" => array:5 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2000"
                        "volumen" => "2"
                        "paginaInicial" => "CD001208"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10796756"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Human albumin solution for resuscitation and volume expansion in critically ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Alderson"
                            1 => "F&#46; Bunn"
                            2 => "C&#46; Lefebvre"
                            3 => "W&#46;P&#46; Li"
                            4 => "L&#46; Li"
                            5 => "I&#46; Roberts"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/14651858.CD001208.pub4"
                      "Revista" => array:4 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2002"
                        "paginaInicial" => "CD001208"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22071799"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient survival after human albumin administration&#46; A meta-analysis of randomized&#44; controlled trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;M&#46; Wilkes"
                            1 => "R&#46;J&#46; Navickis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "2001"
                        "volumen" => "135"
                        "paginaInicial" => "149"
                        "paginaFinal" => "164"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11487482"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A comparison of albumin and saline for fluid resuscitation in the intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Finfer"
                            1 => "R&#46; Bellomo"
                            2 => "N&#46; Boyce"
                            3 => "J&#46; French"
                            4 => "J&#46; Myburgh"
                            5 => "R&#46; Norton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa040232"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2004"
                        "volumen" => "350"
                        "paginaInicial" => "2247"
                        "paginaFinal" => "2256"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15163774"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Albumin administration&#58; what is the evidence of clinical benefit&#46; A systematic review of randomized controlled trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46;R&#46; Haynes"
                            1 => "R&#46;J&#46; Navickis"
                            2 => "M&#46;M&#46; Wilkes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Anaesthesiol"
                        "fecha" => "2003"
                        "volumen" => "20"
                        "paginaInicial" => "771"
                        "paginaFinal" => "793"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14580047"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Morbidity in hospitalized patients receiving human albumin&#58; a metaanalysis of randomized&#44; controlled trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;L&#46; Vincent"
                            1 => "R&#46;J&#46; Navickis"
                            2 => "M&#46;M&#46; Wilkes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2004"
                        "volumen" => "32"
                        "paginaInicial" => "2029"
                        "paginaFinal" => "2038"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15483411"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of albumin in the intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;J&#46; Dubois"
                            1 => "J&#46;L&#46; Vincent"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Opin Crit Care"
                        "fecha" => "2002"
                        "volumen" => "8"
                        "paginaInicial" => "299"
                        "paginaFinal" => "301"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12386489"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Human albumin solution for resuscitation and volume expansion in critically ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Liberati"
                            1 => "L&#46; Moja"
                            2 => "I&#46; Moschetti"
                            3 => "G&#46;F&#46; Gensini"
                            4 => "R&#46; Gusinu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Intern Emerg Med"
                        "fecha" => "2006"
                        "volumen" => "1"
                        "paginaInicial" => "243"
                        "paginaFinal" => "245"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17120476"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Albumin administration improves organ function in critically ill hypoalbuminemic patients&#58; a prospective&#44; randomized&#44; controlled&#44; pilot study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; Dubois"
                            1 => "C&#46; Orellana-Jimenez"
                            2 => "C&#46; Melot"
                            3 => "D&#46; de Backer"
                            4 => "J&#46; Berre"
                            5 => "M&#46; Leeman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.CCM.0000239119.57544.0C"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2006"
                        "volumen" => "34"
                        "paginaInicial" => "2536"
                        "paginaFinal" => "2540"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16915107"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Saline or albumin for fluid resuscitation in patients with traumatic brain injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "The SAFE Study Investigators"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa067514"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2007"
                        "volumen" => "357"
                        "paginaInicial" => "874"
                        "paginaFinal" => "884"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17761591"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is albumin administration in the acutely ill associated with increased mortality&#63; Results of the SOAP study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;L&#46; Vincent"
                            1 => "Y&#46; Sakr"
                            2 => "K&#46; Reinhart"
                            3 => "C&#46;L&#46; Sprung"
                            4 => "H&#46; Gerlach"
                            5 => "V&#46;M&#46; Ranieri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/cc3895"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2005"
                        "volumen" => "9"
                        "paginaInicial" => "R745"
                        "paginaFinal" => "R754"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16356223"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of albumin as a resuscitation fluid for patients with sepsis&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;P&#46; Delaney"
                            1 => "A&#46; Dan"
                            2 => "J&#46; McCaffrey"
                            3 => "S&#46; Finfer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CCM.0b013e3181ffe217"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2011"
                        "volumen" => "39"
                        "paginaInicial" => "386"
                        "paginaFinal" => "391"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21248514"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Specific antioxidant properties of human serum albumin"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Taverna"
                            1 => "A&#46;L&#46; Marie"
                            2 => "J&#46;P&#46; Mira"
                            3 => "B&#46; Guidet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/2110-5820-3-4"
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Intensive Care"
                        "fecha" => "2013"
                        "volumen" => "3"
                        "paginaInicial" => "4"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23414610"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recommendations for the use of albumin and immunoglobulins"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46; Limbruno"
                            1 => "A&#46; Bennardello Lattanzio"
                            2 => "P&#46; Piccoli"
                            3 => "G&#46; Rossetti"
                            4 => "Italian Society of Transfusion Medicine and Immunohaematology &#40;SIMTI&#41;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2450/2009.0094-09"
                      "Revista" => array:7 [
                        "tituloSerie" => "Blood Transfus"
                        "fecha" => "2009"
                        "volumen" => "7"
                        "paginaInicial" => "216"
                        "paginaFinal" => "234"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19657486"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0735109709012121"
                          "estado" => "S300"
                          "issn" => "07351097"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Surviving sepsis campaign&#58; international guidelines for management of severe sepsis and septic shock&#58; 2012"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;P&#46; Dellinger"
                            1 => "M&#46;M&#46; Levy"
                            2 => "A&#46; Rhodes"
                            3 => "D&#46; Annane"
                            4 => "H&#46; Gerlach"
                            5 => "S&#46;M&#46; Opal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2013"
                        "volumen" => "4"
                        "paginaInicial" => "580"
                        "paginaFinal" => "637"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Consensus statement of the ESICM task force on colloid volume therapy in critically ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Konrad"
                            1 => "P&#46; Anders"
                            2 => "L&#46;S&#46; Charles"
                            3 => "J&#46; Roman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-012-2472-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2012"
                        "volumen" => "38"
                        "paginaInicial" => "368"
                        "paginaFinal" => "383"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22323076"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nuevas recomendaciones sobre la utilizaci&#243;n de soluciones de alb&#250;mina humana en pacientes con sepsis grave y shock s&#233;ptico&#46; Una evaluaci&#243;n cr&#237;tica de la literatura"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Latour-P&#233;rez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.medin.2013.03.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2013"
                        "volumen" => "37"
                        "paginaInicial" => "409"
                        "paginaFinal" => "415"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23664006"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical practice guidelines on the management of ascites&#44; spontaneous bacterial peritonitis&#44; and hepatorenal syndrome in cirrhosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "European Association for the Study of the Liver &#40;EASL&#41;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jhep.2010.05.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Hepatol"
                        "fecha" => "2010"
                        "volumen" => "53"
                        "paginaInicial" => "397"
                        "paginaFinal" => "417"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20633946"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of adult patients with ascites due to cirrosis&#58; an update"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "B&#46;A&#46; Runyon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/hep.22853"
                      "Revista" => array:6 [
                        "tituloSerie" => "Hepatology"
                        "fecha" => "2009"
                        "volumen" => "49"
                        "paginaInicial" => "2087"
                        "paginaFinal" => "2107"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19475696"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "Technology assessment&#58; albumin&#44; non-protein colloid&#44; and crystalloid solutions"
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2000"
                        "editorial" => "University HealthSystem Consortium"
                        "editorialLocalizacion" => "Oak Brook&#44; IL"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Medimecum 2010&#46; Gu&#237;a de terapia farmacol&#243;gica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "L&#46;F&#46; Villa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:6 [
                        "edicion" => "15th ed&#46;"
                        "fecha" => "2010"
                        "paginaInicial" => "204"
                        "paginaFinal" => "205"
                        "editorial" => "ADIS"
                        "editorialLocalizacion" => "Espa&#241;a"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Colloids versus crystalloids for fluid resuscitation in critically ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Perel"
                            1 => "I&#46; Roberts"
                            2 => "K&#46; Ker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/14651858.CD000567.pub6"
                      "Revista" => array:5 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2013"
                        "volumen" => "2"
                        "paginaInicial" => "CD000567"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23450531"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "GRADE&#58; an emerging consensus on rating quality of evidence and strenght of recommendations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:7 [
                            0 => "G&#46;H&#46; Guyatt"
                            1 => "A&#46;D&#46; Oxman"
                            2 => "G&#46;E&#46; Vist"
                            3 => "R&#46; Kunz"
                            4 => "Y&#46; Falck-Ytter"
                            5 => "P&#46; Alonso-Coello"
                            6 => "GRADE Working Group"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmj.39489.470347.AD"
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2008"
                        "volumen" => "336"
                        "paginaInicial" => "924"
                        "paginaFinal" => "926"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18436948"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735727/0000003800000007/v1_201410030040/S2173572714000563/v1_201410030040/en/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/21735727/0000003800000007/v1_201410030040/S2173572714000563/v1_201410030040/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572714000563?idApp=WMIE"
]
Article information
ISSN: 21735727
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 11 8 19
2024 October 79 84 163
2024 September 69 57 126
2024 August 78 78 156
2024 July 63 45 108
2024 June 71 63 134
2024 May 66 36 102
2024 April 69 33 102
2024 March 51 34 85
2024 February 39 36 75
2024 January 43 32 75
2023 December 55 48 103
2023 November 50 22 72
2023 October 45 49 94
2023 September 50 54 104
2023 August 31 22 53
2023 July 41 30 71
2023 June 69 16 85
2023 May 88 49 137
2023 April 61 29 90
2023 March 76 32 108
2023 February 79 42 121
2023 January 71 26 97
2022 December 71 56 127
2022 November 89 57 146
2022 October 92 56 148
2022 September 80 42 122
2022 August 55 41 96
2022 July 43 37 80
2022 June 49 41 90
2022 May 40 37 77
2022 April 49 43 92
2022 March 64 67 131
2022 February 56 35 91
2022 January 68 55 123
2021 December 48 51 99
2021 November 46 40 86
2021 October 73 78 151
2021 September 48 46 94
2021 August 37 50 87
2021 July 47 39 86
2021 June 35 31 66
2021 May 84 57 141
2021 April 163 125 288
2021 March 87 35 122
2021 February 90 40 130
2021 January 80 40 120
2020 December 60 33 93
2020 November 75 22 97
2020 October 62 33 95
2020 September 51 17 68
2020 August 61 17 78
2020 July 62 16 78
2020 June 63 18 81
2020 May 57 22 79
2020 April 45 25 70
2020 March 54 33 87
2020 February 136 70 206
2020 January 49 36 85
2019 December 83 32 115
2019 November 147 47 194
2019 October 82 33 115
2019 September 57 34 91
2019 August 62 31 93
2019 July 55 27 82
2019 June 14 31 45
2019 May 51 21 72
2019 April 25 16 41
2019 March 29 17 46
2019 February 30 27 57
2019 January 23 26 49
2018 December 63 31 94
2018 November 86 47 133
2018 October 123 27 150
2018 September 54 13 67
2018 August 25 9 34
2018 July 34 10 44
2018 June 35 12 47
2018 May 26 4 30
2018 April 87 9 96
2018 March 32 4 36
2018 February 69 5 74
2018 January 65 6 71
2017 December 94 7 101
2017 November 33 5 38
2017 October 30 6 36
2017 September 17 8 25
2017 August 15 7 22
2017 July 17 8 25
2017 June 32 9 41
2017 May 28 8 36
2017 April 25 12 37
2017 March 21 4 25
2017 February 15 5 20
2017 January 13 2 15
2016 December 40 3 43
2016 November 54 14 68
2016 October 61 21 82
2016 September 43 12 55
2016 August 33 3 36
2016 July 28 7 35
Show all

Follow this link to access the full text of the article

Idiomas
Medicina Intensiva (English Edition)
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?