Is hyperoncotic albumin administration an unrecognized resuscitation risk factor? The use of hyperoncotic albumin (HA) for shock resuscitation is controversial given concerns about its cost, effectiveness, and potential for nephrotoxicity. We evaluated the association between early exposure to hyperoncotic albumin (within the first 48 h of onset of shock) and acute organ dysfunction in post-surgical patients with shock. Early exposure to hyperoncotic albumin in postoperative shock appeared to be associated with acute kidney injury (AKI). There did not appear to be any association with hepatic injury, mortality, or ICU days. The clinical and economic implications of this finding warrant further investigation. This retrospective, cohort study included 11,512 perioperative patients with shock from 2009 to 2012.

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