6533b7cffe1ef96bd1258f9a
RESEARCH PRODUCT
Albumin replacement therapy in immunocompromised patients with sepsis - Secondary analysis of the ALBIOS trial
Antonino GiarratanoAntonio PesentiAlessandra MoscarelliChiara Maria BonentiRoberto LatiniJennifer MeessenPietro CaironiAndrea CortegianiCarlo Alberto VoltaGiacomo GrasselliGiacomo GrasselliGiacomo BellaniMariachiara IppolitoStefano RomagnoliFabrizio Turvanisubject
medicine.medical_specialtySepsimedicine.medical_treatmentSocio-culturaleCritical Care and Intensive Care MedicineSepsisAlbumin; Immunocompromised; Immunodeficiency; Sepsis; Septic shock03 medical and health sciencesImmunocompromised Host0302 clinical medicineInternal medicineSepsisAlbuminsSeptic shockmedicineHumansImmunodeficiencyRenal replacement therapyAlbumin; Immunocompromised; Immunodeficiency; Sepsis; Septic shock; Albumins; Crystalloid Solutions; Fluid Therapy; Humans; Immunocompromised Host; Sepsis; Shock SepticImmunocompromisedMechanical ventilationSeptic shockbusiness.industrySepticAlbuminHazard ratioAcute kidney injuryAlbumin030208 emergency & critical care medicineShockCrystalloid Solutionsmedicine.diseaseShock Septic030228 respiratory systemFluid TherapySOFA scorebusinessdescription
Abstract Background The best fluid replacement strategy and the role of albumin in immunocompromised patients with sepsis is unclear. Methods We performed a secondary analysis of immunocompromised patients enrolled in the ALBIOS trial which randomized patients with severe sepsis or septic shock to receive either 20% albumin (target 30 g per liter or more) and crystalloid or crystalloid alone during ICU stay. Results Of 1818 patients originally enrolled, 304 (16.4%) were immunocompromised. One-hundred-thirty-nine (45.7%) patients were randomized in the albumin while 165 (54.2%) in the crystalloid group. At 90 days, 69 (49.6%) in the albumin group and 89 (53.9%) in the crystalloids group died (hazard ratio - HR - 0.94; 95% CI 0.69–1.29). No differences were observed with regards to 28-day mortality, SOFA score (and sub-scores), length of stay in the ICU and in the hospital, proportion of patients who had developed acute kidney injury or received renal replacement therapy, duration of mechanical ventilation. Albumin was not independently associated with a higher or lower 90-day mortality (HR 0.979, 95% CI 0.709–1.352) as compared to crystalloid. Conclusion Albumin replacement during the ICU stay, as compared with crystalloids alone, did not affect clinical outcomes in a cohort of immunocompromised patients with sepsis.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-01-01 |