Lactated Ringer's Versus 4% Albumin on Lactated Ringer's in Early Sepsis Therapy in Cancer Patients: A Pilot Single-Center Randomized Trial

Clarice Hyesuk Lee Park, Juliano Pinheiro de Almeida, Gisele Queiroz de Oliveira, Stéphanie Itala Rizk, Julia Tizue Fukushima, Rosana Ely Nakamura, Matheus Moraes Mourão, Filomena Regina Barbosa Gomes Galas, Edson Abdala, Maristela Pinheiro Freire, Roberto Kalil Filho, Jose Otavio Costa Auler, Pasquale Nardelli, Greg S. Martin, Giovanni Landoni, Ludhmila Abrahao Hajjar

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: To investigate the effects of the administration of 4% albumin on lactated Ringer's, when compared with lactated Ringer's alone, in the early phase of sepsis in cancer patients. DESIGN: Single-center, randomized, double-blind, controlled-parallel trial. SETTING: A tertiary care university cancer hospital. PATIENTS: Cancer patients with severe sepsis or septic shock. INTERVENTIONS: Between October 2014 and December 2016, patients were randomly assigned to receive either bolus of albumin in a lactated Ringer's solution or lactated Ringer's solution alone during the first 6 hours of fluid resuscitation after intensive care medicine (ICU) admission. Primary outcome was defined as death from any cause at 7 days. Secondary outcomes were defined as death from any cause within 28 days, change in Sequence Organ Failure Assessment scores from baseline to day 7, days alive and free of mechanical ventilation, days alive and free of vasopressor, renal replacement therapy during ICU stay, and length of ICU and hospital stay. MEASUREMENTS AND MAIN RESULTS: A total of 360 patients were enrolled in the trial. At 7 days, 46 of 180 patients (26%) died in the albumin group and 40 of 180 (22%) died in the lactated Ringer's group (p = 0.5). At 28 days, 96 of 180 patients (53%) died in the albumin group and 83 of 180 (46%) died in the lactated Ringer's group (p = 0.2). No significant differences in secondary outcomes were observed. CONCLUSIONS: Adding albumin to early standard resuscitation with lactated Ringer's in cancer patients with sepsis did not improve 7-day survival.

Original languageEnglish
Pages (from-to)e798-e805
JournalCritical Care Medicine
Volume47
Issue number10
DOIs
Publication statusPublished - Oct 1 2019

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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