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Thursday, July 23, 1998 Published at 23:06 GMT 00:06 UK


Health

Blood product may have 'killed thousands'

Critically injured burns victims may have been killed

A blood product used in the emergency treatment of patients with injuries and burns for more than 50 years may have caused thousands of deaths.


The BBC's Fergus Walsh: 'Albumin is already being used less and less'
A report by the Cochrane Injuries Group, an international body which assesses trials and treatments for their effectiveness, calls for an urgent review of the use of human albumin solution in critically ill patients.


[ image: The product is given via an intravenous drip]
The product is given via an intravenous drip
A government group of experts has already begun to study the Cochrane conclusions, but officials said more evidence was needed before restrictions on albumin could be justified.

Albumin solution, refined from donated blood, is used in the treatment of approximately 100,000 patients each year in the UK.

The researchers stress that the threat only exists while patients are critically ill.


Dr Ian Roberts discusses the research
Albumin is used to treat burns victims, people suffering from severe shock, and those with illnesses accompanied by abnormally low levels of protein in the blood (hypoproteinaemia).

However many hospitals have switched in recent years to cheaper saline or synthetic solutions which produce the same effect.

The Cochrane group conducted a review of 30 clinical trials that included 1,419 patients.

Higher risk


[ image: Dr Ian Roberts: 'thousands have died']
Dr Ian Roberts: 'thousands have died'
The results, reported in the British Medical Journal, showed the risk of death in patients treated with albumin was 6% higher than in patients not given albumin.

Researcher Dr Ian Roberts, of the Institute of Child Health at University College, London, said albumin could be linked to approximately 600 deaths a year.

Dr Roberts said it was "extraordinary" that the risks had not been detected before.

The reasons why albumin treatment may increase mortality rates is not known.

Albumin is one of the most important blood proteins and serves various functions.

It helps keep substances such as calcium, some hormones and certain drugs in the circulation by preventing them being excreted in the urine, and also regulates the movement of water between the tissues and the bloodstream.

However, the protein is also believed to have anticoagulant properties, which may prove detrimental in critically ill patients suffering from haemorrhages.

Adding albumin to the body may also lead to dangerous leakages from blood vessels by altering the delicate balance of fluid concentrations needed for the circulatory system to work.

Research caveats

While warning that their findings must be treated with caution as the clinical trials were relatively small, the authors conclude: "We believe that a reasonable conclusion from these results is that the use of human albumin in the management of critically ill patients should be reviewed.

The researchers also said their findings suggested there was a strong argument for not allowing the treatment outside strictly controlled trials.

Writing about the Cochrane research in the BMJ, Dr Martin Offringa, a consultant neonatologist at Emma Children's Hospital, Amsterdam, also called for the use of albumin to be halted until the results of a larger clinical trial are available.

Albumin was reportedly first used to treat American victims of the Japanese attack on Pearl Harbour in 1941.

The NHS currently uses 7.5 tonnes of albumin a year at a cost of £12m. Foreign plasma has to be imported to produce the solution as British blood is deemed unsafe due to the BSE crisis.



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