Thirdly, the fear of pulmonary edema from overhydration may be exaggerated in general, since Maitland et al. could demonstrate in children with severe malaria with or without anaemia, that volume resuscitation with albumin or saline does not lead to an increased risk of cardio-respiratory deterioration or pulmonary edema compared to the control group [14,15]. Here, ALB is linked to anemia (phenotype).