Journal article
A Prospective, Randomized, Multicenter Trial Comparing Lactated Ringer's Alone or With 5% Albumin for Resuscitation of Large Burns The Acute Burn ResUscitation Multicenter Prospective Trial 2 (ABRUPT2)
Annals of surgery
05/18/2026
DOI: 10.1097/SLA.0000000000007096
PMID: 42144653
Abstract
ABRUPT2 was a prospective, randomized, multicenter trial to determine whether lactated Ringer's + 5% albumin (Alb) reduces resuscitation requirements compared to lactated Ringer's (LR) alone in major burns.
The prospective, observational, multicenter ABRUPT study(1) found that initiation of albumin rapidly lowered fluid input and improved urine output in patients with burns ≥ 20% TBSA.
Based on the ABRUPT trial, inclusion was increased to ≥ 25% TBSA and ≥ 20% full-thickness. Patients ≥ 18 years were randomized to receive LR or Alb (2/3 LR + 1/3 5% albumin) for initial resuscitation. The initial rate was 2-4 ml/kg/% TBSA and adjusted to urine output (0.5-1 mL/kg/hour). For safety or excessive fluid volumes (> 250 mL/kg in 24 hours), investigators could crossover between assigned study arms.
The study was stopped at 99 subjects (Alb-48, LR-51) due to declining enrollment in 19/27 centers. Mean % TBSA burn was 46%. Twenty-six (51%) LR patients crossed over to Alb, but there were no crossovers from Alb to LR. Despite crossovers, following intention-to-treat, there were statistically significant (p 0.001) increased fluids at 24 and 48 hours for the LR group compared to Alb. The LR group averaged 1.5 (95% CI: 0.59,2.3) ml/kg/%TBSA and 2.1 (95% CI: 1.0,3.1) ml/kg/%TBSA times higher fluids compared to Alb at 24 and 48 hours, respectively. There were no differences in mortality, time to healing or acute kidney injury.
The use of 5% albumin significantly reduced fluid requirements compared to LR alone in the first 48 hours after injury.
Details
- Title: Subtitle
- A Prospective, Randomized, Multicenter Trial Comparing Lactated Ringer's Alone or With 5% Albumin for Resuscitation of Large Burns The Acute Burn ResUscitation Multicenter Prospective Trial 2 (ABRUPT2)
- Creators
- David G Greenhalgh - Shriners Hospitals for Children - Northern CaliforniaRobert Cartotto - University of TorontoSandra Taylor - University of California, DavisJeffrey Fine - University of California, DavisDavid Wallace - University of TorontoMahmoud Hassouba - University of Tennessee Health Science CenterSai R Velamuri - University of South FloridaMichael Marano - Saint Barnabas Medical CenterJulia Slater - University of CincinnatiNiknam Eshraghi - Legacy HealthPeter Kwan - University of AlbertaLucy Wibbenmeyer - University of IowaAngela Gibson - University of Wisconsin–MadisonJoseph Turkowski - Westchester Medical CenterFrancis Winski - Westchester Medical CenterJames Holmes IV - Department of Surgery, Wake Forrest University School of Medicine, Winston-Salem, NCJustin Dvorak - MetroHealthJeffrey Claridge - MetroHealthSarah Fischer - Ascension Via ChristiAndrea Munden - University of FloridaJohn C Kubasiak - Loyola University ChicagoDhaval Bhavsar - University of KansasTam Pham - University of WashingtonShevonne Satahoo - University of MiamiNicholas Meyer - Columbia St. Mary's Hospital
- Resource Type
- Journal article
- Publication Details
- Annals of surgery
- DOI
- 10.1097/SLA.0000000000007096
- PMID
- 42144653
- NLM abbreviation
- Ann Surg
- ISSN
- 0003-4932
- eISSN
- 1528-1140
- Publisher
- Lippincott
- Language
- English
- Electronic publication date
- 05/18/2026
- Academic Unit
- Surgery; Injury Prevention Research Center
- Record Identifier
- 9985164606302771
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