Initial Resuscitation With Albumin in Hemorrhagic Shock to Reduce Positive Fluid Balance

Inclusion Criteria: * Adult patients (19 or older) * Admitted or planned to admit surgical intensive care unit * Patients with decreased hemoglobin level more than 20% from baseline within 12 hours, Or * Patients who are suspected bleeding and hemodynamically unstable requiring more than 0.05mcg/kg/min of norepinephrine infusion to maintain mean blood pressure higher than 65mmHg Exclusion Criteria: * Contraindicated to albumin product * patients with risk factors of increased circulatory volume (heart failure, pulmonary edema, end-stage renal disease with oliguria) * patients with hemolytic anemia * History of anaphylactic reaction to blood product