Albumin replacement therapy in immunocompromised patients with sepsis - Secondary analysis of the ALBIOS trial

被引：3

作者：

Cortegiani, Andrea ^{[1
]}

Grasselli, Giacomo ^{[2
,3
]}

Meessen, Jennifer ^{[4
]}

Moscarelli, Alessandra ^{[1
]}

Ippolito, Mariachiara ^{[1
]}

Turvani, Fabrizio ^{[5
,6
]}

Bonenti, Chiara Maria ^{[7
]}

Romagnoli, Stefano ^{[8
,9
]}

Volta, Carlo Alberto ^{[10
]}

Bellani, Giacomo ^{[11
,12
]}

Giarratano, Antonino ^{[1
]}

Latini, Roberto ^{[3
]}

Pesenti, Antonio ^{[2
]}

Caironi, Pietro ^{[4
,5
]}

机构：

[1] Univ Palermo, Dept Surg Oncol & Oral Sci DiChirOnS, Policlin Paolo Giaccone, Dept Anaesthesia Intens Care & Emergency, Palermo, Italy

[2] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Dipartimento Anestesia Rianimaz & Emergenza Urgen, I-20122 Milan, Italy

[3] Univ Milan, Dept Pathophysiol & Transplantat, Milan, Italy

[4] Ist Ric Farmacol Mario Negri IRCCS, Dept Cardiovasc Med, Milan, Italy

[5] Azienda Osped Univ S Luigi Gonzaga, Dept Anesthesia & Crit Care, Orbassano, Italy

[6] Univ Torino, Dipartimento Oncol, Turin, Italy

[7] ASST Grande Osped Metropolitano Niguarda Anestesi, Milan, Italy

[8] Univ Florence, Azienda Osped Univ Careggi, Dept Hlth Sci, Florence, Italy

[9] Azienda Osped Univ Careggi, Dept Anesthesia & Crit Care, Florence, Italy

[10] Univ Ferrara, Azienda Osped Univ Arcispedale St Anna, Dept Morphol Surg & Expt Med, Ferrara, Italy

[11] Univ Milano Bicocca, Dept Med & Surg, Monza, Italy

[12] San Gerardo Hosp, Dept Emergency & Intens Care, Monza, Italy

来源：

JOURNAL OF CRITICAL CARE | 2021年 / 63卷

关键词：

Albumin; Sepsis; Septic shock; Immunocompromised; Immunodeficiency; CRITICALLY-ILL PATIENTS; SEPTIC SHOCK DATA; SERUM-ALBUMIN; MANAGEMENT; CANCER; MORTALITY; OUTCOMES; MARKER;

D O I：

10.1016/j.jcrc.2021.01.016

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

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. (c) 2021 Elsevier Inc. All rights reserved.

引用

页码：83 / 91

页数：9

共 34 条

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