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Several brain regions showed robust responses to shock anticipation relative to safe trials, including the hypothalamus, periaqueductal gray, caudate, precentral gyrus, thalamus, insula, ventrolateral PFC, dorsomedial PFC, and ACC.
What are the implications of the SOAP and SAFE trials for albumin use and future albumin research?
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Dr. Hodis of the National Institute on Aging said he was determined to keep looking for a way to design a safe trial and was planning a major conference to discuss the matter.
Although the SAFE trial showed no increase in mortality with albumin compared with saline, it is difficult to justify its use in critical care given its considerably greater cost.
Importantly, the large multicenter SAFE trial, published in 2004 [66], showed no difference in mortality with the use of albumin versus NS, with the exception of the subgroup of traumatic brain injury (TBI) patients whose outcomes were worse with albumin [67].
Martin [ 28] and SAFE trial: no evidence of other sources of bias.
The HABITS ('hormonal replacement therapy after breast cancer – is it safe?') trial is a good example of this.
The study of saline versus albumin fluid evaluation (SAFE trial) used 4% albumin compared to saline [ 30].
The SAFE trial randomized 7,000 critically ill patients requiring fluid resuscitation to receive isotonic saline or iso-oncotic albumin [ 6].
That finding could not be replicated either in the SAFE trial [ 25] or a more comprehensive subsequent meta-analysis [ 27].
During the time that the SOAP study was being conducted, the Saline versus Albumin Fluid Evaluation (SAFE) trial was underway.
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