1. Albumin replacement therapy in immunocompromised patients with sepsis - Secondary analysis of the ALBIOS trial
- Author
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Antonino Giarratano, Antonio Pesenti, Alessandra Moscarelli, Chiara Maria Bonenti, Roberto Latini, Jennifer Meessen, Pietro Caironi, Andrea Cortegiani, Carlo Alberto Volta, Giacomo Grasselli, Giacomo Bellani, Mariachiara Ippolito, Stefano Romagnoli, Fabrizio Turvani, Cortegiani, A, Grasselli, G, Meessen, J, Moscarelli, A, Ippolito, M, Turvani, F, Bonenti, C, Romagnoli, S, Volta, C, Bellani, G, Giarratano, A, Latini, R, Pesenti, A, Caironi, P, Cortegiani, Andrea, Grasselli, Giacomo, Meessen, Jennifer, Moscarelli, Alessandra, Ippolito, Mariachiara, Turvani, Fabrizio, Bonenti, Chiara Maria, Romagnoli, Stefano, Volta, Carlo Alberto, Bellani, Giacomo, Giarratano, Antonino, Latini, Roberto, Pesenti, Antonio, and Caironi, Pietro
- Subjects
medicine.medical_specialty ,Sepsi ,medicine.medical_treatment ,Socio-culturale ,Critical Care and Intensive Care Medicine ,Sepsis ,Albumin ,Immunocompromised ,Immunodeficiency ,Septic shock ,03 medical and health sciences ,Immunocompromised Host ,0302 clinical medicine ,Internal medicine ,Albumins ,medicine ,Humans ,Renal replacement therapy ,Crystalloid Solutions ,Fluid Therapy ,Shock, Septic ,Mechanical ventilation ,business.industry ,Septic ,Hazard ratio ,Acute kidney injury ,030208 emergency & critical care medicine ,Shock ,medicine.disease ,030228 respiratory system ,SOFA score ,business - 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.
- Published
- 2021