Albumin Administration in the Septic Patient
Theoretical Framework
The theoretical model used for this project proposal was the Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP). The JHNEBP model was used to guide the formation of a practice question and evaluate evidence related to the question. The question used in this proposal is, “In adult patients with sepsis, how does albumin administration compared to crystalloid administration affect perioperative patient outcomes?” This question guided our search of the available literature regarding the utilization of albumin in the fluid resuscitation of septic patients and the long-term implications of albumin use.
Search Process
The search process for evidence began with resources provided by MTSA through the Nelda F. Ackerman Learning Resource Center (LRC). The databases utilized included CINAHL by Ebsco, PubMed, Ovid, and Google Scholar, with each explored with key search terms and Boolean operators applied. The first key search term was “anesthesia” with the Boolean operator -OR- applied to the following terms: anesthesiology, surgery, procedure, perioperative, inpatient, outpatient, medical-surgical ICU, and surgical ICU. The second key search term was "sepsis," with the Boolean operator -OR- applied to the following terms: septic, septic shock, systemic infection, systemic inflammation, and membrane permeability. The final key search term was "albumin," with the Boolean operator -OR- applied to the following terms: colloid, plasma protein, and hypoalbuminemia. Each key search string was linked with the Boolean operator -AND- to ensure essential details were addressed in some capacity. Various combinations and permutations of the search string were utilized for thoroughness.