TY - JOUR
T1 - Albumin replacement therapy in immunocompromised patients with sepsis – Secondary analysis of the ALBIOS trial
AU - Cortegiani, Andrea
AU - Grasselli, Giacomo
AU - Meessen, Jennifer
AU - Moscarelli, Alessandra
AU - Ippolito, Mariachiara
AU - Turvani, Fabrizio
AU - Bonenti, Chiara Maria
AU - Romagnoli, Stefano
AU - Volta, Carlo Alberto
AU - Bellani, Giacomo
AU - Giarratano, Antonino
AU - Latini, Roberto
AU - Pesenti, Antonio
AU - Caironi, Pietro
N1 - Publisher Copyright:
© 2021
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/6
Y1 - 2021/6
N2 - 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.
AB - 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.
KW - Albumin
KW - Immunocompromised
KW - Immunodeficiency
KW - Sepsis
KW - Septic shock
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U2 - 10.1016/j.jcrc.2021.01.016
DO - 10.1016/j.jcrc.2021.01.016
M3 - Article
AN - SCOPUS:85101210843
VL - 63
SP - 83
EP - 91
JO - Journal of Critical Care
JF - Journal of Critical Care
SN - 0883-9441
ER -