Another multi-center RCT in adults with severe sepsis or septic shock with a negative result. This time 1800 adults in 100 ICUs in Italy were randomized. Fluid boluses were either crystalloid or 20% albumin and crystalloid. Blood pressure was somewhat higher in the albumin group (by a massive 2 mmHg in the mean BP on day 1 and 1 mmHg on day 2), and they had a better short term fluid balance. There were no differences in any clinically important outcome, including the primary outcome of mortality.

The study confirms once more that severe sepsis is bad for you, mortality in both groups was around 40%.