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In preclinical models in rodents, infusion of albumin in the setting of acute ischemic stroke led to reductions in cerebral edema and infarction size; there was also evidence of improvements in microvascular flow. In a phase III trial, the ALIAS investigators assessed the hypothesis that albumin administration within 5 hours of stroke onset would improve neurologic recovery as measured by the Rankin scale or the NIH stroke scale. A total of 841 patients were randomized to treatment with 25% albumin (2 g/kg) or the equivalent volume of isotonic saline. The use of thrombolytic medication was allowed.
The study was stopped early due to futility: The proportion of patients achieving a good neurologic outcome at 90 days was 44% in both the albumi…