Feasibility of 5% Albumin Compared With Balanced Crystalloid, as Intravenous Fluid Resuscitation in Adult Patients With Sepsis, Presenting as an Emergency to Hospital

Inclusion Criteria

Adult patients (18 years or older) who present to UK NHS hospitals with community acquired sepsis meeting all of the 4 criteria:

• Clinically suspected or proven infection resulting in principal reason for acute illness;
• NEWS score ≥5 (or NEWS2 if adopted in recruitment site);
• Hospital presentation within last 12hrs; and
• Clinician decision has been made that immediate (within 1 hour) intravenous fluid resuscitation is needed.

Exclusion Criteria

• >1 litre of intravenous crystalloid fluid or any intravenous HAS administered prior to eligibility assessment;
• Requirement for immediate surgery (within one hour of eligibility assessment);
• Chronic renal replacement therapy;
• Known allergy/adverse reaction to HAS;
• Balanced crystalloid or HAS not available;
• Known adverse reaction to blood products;
• Palliation/end of life care (explicit decision by patient/family/carers in conjunction with clinical team that any active treatment beyond symptomatic relief is not appropriate);
• Religious beliefs precluding HAS administration;
• Previous recruitment in the trial;
• Known recent severe traumatic brain injury (within 3 months);
• Patients with permanent incapacity;
• Known recruitment in another CTIMP studies within the last 30 days where co-enrolment has not been agreed.