The impact of Albumin Administration on Mortality and Resuscitation Volume in Burn Resuscitation: A Systematic Review and Meta-Analysis.

Objective: This systematic review and meta-analysis aimed to evaluate the impact of albumin administration on mortality and total resuscitation volume in burn patients. Methods: We systematically searched ScienceDirect, Cochrane, PubMed, MEDLINE, Scopus, and ProQuest in June 2025 using the terms "Burns," "Resuscitation," and "Albumin." Studies were included if they investigated albumin as part of burn resuscitation in adult patients and reported on mortality and total resuscitation volume. Pediatric studies, studies using albumin for other purposes, and those using other colloids were excluded. Reviewers independently extracted data on study characteristics, patient demographics, and outcomes. The risk of bias was assessed using RoB 2 for RCTs and ROBINS-I for non-randomized studies (NRCTs). Pooled analyses were performed using Review Manager 9.3.0, applying random-effects models. Results: Eleven of the 7,365 identified articles were included. Albumin administration did not significantly affect mortality (OR=1.19 [0.62-2.28], p=0.57) or total resuscitation volume (OR=0.69 [-0.93-2.31], p=0.34). However, albumin use was associated with a reduced incidence of sepsis (OR=1.18 [1.02-1.38], p=0.03) and ARDS (OR=2.64 [1.43-4.86], p=0.02). Conclusion: The administration of albumin did not significantly impact mortality or resuscitation volume in burn patients. While there is some evidence of potential benefits in reducing complications, this is limited by heterogeneity, underscoring the need for further high-quality RCTs.