ALB and Shock: However, two RCTs, the Saline versus Albumin Fluid Evaluation (SAFE) and the Albumin Italian Outcome Sepsis (ALBIOS) study, as well as a meta-analysis of randomized clinical trials, compared the effect of albumin and crystalloid use in patients with sepsis or septic shock, and showed a trend towards reduced mortality and improved outcomes in the albumin group, without observing serious side effects [63,64,65].