albumin infusion
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2021 ◽  
Vol 50 (1) ◽  
pp. 224-224
Author(s):  
W. Ray Kim ◽  
Karthik. Raghunathan ◽  
Greg Martin ◽  
E. Anne Davis ◽  
Navreet Sindhwani ◽  
...  

2021 ◽  
Vol 50 (1) ◽  
pp. 224-224
Author(s):  
W. Ray Kim ◽  
Karthik. Raghunathan ◽  
Greg Martin ◽  
E. Anne Davis ◽  
Navreet Sindhwani ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chenglong Ge ◽  
Qianyi Peng ◽  
Wei Chen ◽  
Wenchao Li ◽  
Lina Zhang ◽  
...  

AbstractSeptic shock with acute kidney injury (AKI) is common in critically ill patients. Our aim was to evaluate the association between albumin infusion and outcomes in patients with septic shock and AKI. Medical Information Mart for Intensive Care (MIMIC)-III was used to identify patients with septic shock and AKI. Propensity score matching (PSM) was employed to balance the baseline differences. Cox proportional hazards model, Wilcoxon rank-sum test, and logistic regression were utilized to determine the associations of albumin infusion with mortality, length of stay, and recovery of kidney function, respectively. A total of 2861 septic shock patients with AKI were studied, including 891 with albumin infusion, and 1970 without albumin infusion. After PSM, 749 pairs of patients were matched. Albumin infusion was associated with improved 28-day survival (HR 0.72; 95% CI 0.59–0.86; P = 0.002), but it was not difference in 90-day mortality between groups (HR 0.94; 95% CI 0.79–1.12; P = 0.474). Albumin infusion was not associated with the renal function recovery (HR 0.91; 95% CI 0.73–1.13; P = 0.393) in either population. Nevertheless, subgroup analysis showed that albumin infusion was distinctly associated with reduced 28-day mortality in patients with age > 60 years. The results need to be validated in more randomized controlled trials.


PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260312
Author(s):  
Tao Han Lee ◽  
George Kuo ◽  
Chih-Hsiang Chang ◽  
Yen Ta Huang ◽  
Chieh Li Yen ◽  
...  

Background It has been a matter of much debate whether the co-administration of furosemide and albumin can achieve better diuresis and natriuresis than furosemide treatment alone. There is inconsistency in published trials regarding the effect of this combination therapy. We, therefore, conducted this meta-analysis to explore the efficacy of furosemide and albumin co-administration and the factors potentially influencing the diuretic effect of such co-administration. Methods In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched the PubMed, Embase, Medline, and Cochrane databases. Prospective studies with adult populations which comparing the effect of furosemide and albumin co-administration with furosemide alone were included. The outcomes including diuretic effect and natriuresis effect measured by hourly urine output and hourly urine sodium excretion from both groups were extracted. Random effect model was applied for conducting meta-analysis. Subgroup analysis and sensitivity analysis were performed to explore potential sources of heterogeneity of treatment effects. Results By including 13 studies with 422 participants, the meta-analysis revealed that furosemide with albumin co-administration increased urine output by 31.45 ml/hour and increased urine excretion by 1.76 mEq/hour in comparison to furosemide treatment alone. The diuretic effect of albumin and furosemide co-administration was better in participants with low baseline serum albumin levels (< 2.5 g/dL) and high prescribed albumin infusion doses (> 30 g), and the effect was more significant within 12 hours after administration. Diuretic effect of co-administration was better in those with baseline Cr > 1.2 mg/dL and natriuresis effect of co-administration was better in those with baseline eGFR < 60 ml/min/1.73m2. Conclusion Co-administration of furosemide with albumin might enhance diuresis and natriuresis effects than furosemide treatment alone but with high heterogeneity in treatment response. According to the present meta-analysis, combination therapy might provide advantages compared to the furosemide therapy alone in patients with baseline albumin levels lower than 2.5 g/dL or in patients receiving higher albumin infusion doses or in patients with impaired renal function. Owing to high heterogeneity and limited enrolled participants, further parallel randomized controlled trials are warranted to examine our outcome. Registration PROSEPRO ID: CRD42020211002; https://clinicaltrials.gov/.


2021 ◽  
Vol 7 (1) ◽  
pp. 15-20
Author(s):  
Nina Mariana ◽  
◽  
Surya Oto Wijaya ◽  
Siti Maemun ◽  
Nafrialdi Nafrialdi ◽  
...  

Background: Hypoalbuminemia is frequent among hospitalized patients and is associated with poor outcomes. ICU patients are widely associated with more severe condition making albumin correction seems to be less effective. This study was aimed to compare the results of albumin correction in ICU and non-ICU patients at Sulianti Saroso Hospital, Jakarta. Methods: A cross sectional study was conducted on adult patients in ICU and non-ICU wards who received intravenous albumin infusion at Sulianti Saroso hospital, between January 2013 to March 2018. Paired t-test was used to analyze the changes of albumin level before and after albumin infusion. Results: 123 ICU patients (41 sepsis, 82 non-sepsis) and 206 non-ICU patients (34 sepsis, 172 non-sepsis) who received 20% or 25% albumin infusions were included. Significant increase in albumin levels were observed in sepsis patients both in ICU and non-ICU, while in non-sepsis patients, the significant increase only observed in non-sepsis patients. Overall, mean increase in albumin levels in ICU-and non-ICU patients were 0.13 (0.63) g/dL vs 0.35(0.54) g/dL, respectively (P= < 0,001). Conclusion: Non-ICU patients show better response to albumin infusion compared to ICU patients. This difference is presumably due to different degree of inflammation. It is suggested that the quantity needed for albumin infusion is calculated differently according to clinical condition of the patients


2021 ◽  
Author(s):  
Yifei Ma ◽  
Tianao Yan ◽  
Fengshuo Xu ◽  
Jiachun Ding ◽  
Bao Yang ◽  
...  

Abstract Objective: Human serum albumin (HSA) infusion is a common administration in acute pancreatitis patients in the Intensive Care Unit (ICU), but its actual association with patients' outcomes has not been confirmed. The study was aimed to determine whether the in-hospital prognosis of ICU patients with acute pancreatitis could benefit from albumin infusion. Methods: 950 acute pancreatitis patients diagnosed in 2008-2019 were extracted from the MIMIC-IV database as our primary study cohort. The primary outcome was in-hospital mortality. We also performed an external validation with a cohort of 104 acute pancreatitis patients after PSM matching from the eICU database. Results: In MIMIC-IV, 228 acute pancreatitis patients received HSA infusion (Alb group) during their hospitalization, while 722 patients did not (non-Alb group). Patients in the Alb group presented a poorer survival curve than the non-Alb group, while this difference disappeared after PSM or IPTW matching (log-rank test: PSM: p = 0.660, IPTW: p = 0.760). After including covariates, no association was found between albumin infusion and patients' in-hospital mortality before and after matching (original cohort: HR: 1.00, 95% CI: 0.66–1.52, p = 0.998). HSA infusion also did not benefit patients' 28-day or ICU mortality, while it significantly prolonged their duration in hospital and ICU. In addition, the initial serum albumin levels, infections or the amount of total albumin infusion did not affect the conclusion. Finally, in the eICU cohort, albumin infusion was still not a beneficial prognostic factor on patients' in-hospital mortality ( p = 0.087).Conclusion: Intravenous albumin infusion could not benefit acute pancreatitis patients' in-hospital prognosis and possibly prolong the hospital or ICU duration.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Bo Liu ◽  
Junpeng Pan ◽  
Hui Zong ◽  
Zhijie Wang

Abstract Background Perioperative hypoalbuminemia of the posterior lumbar interbody fusion (PLIF) can increase the risk of infection of the incision site, and it is challenging to accurately predict perioperative hypoproteinemia. The objective of this study was to create a clinical predictive nomogram and validate its accuracy by finding the independent risk factors for perioperative hypoalbuminemia of PLIF. Methods The patients who underwent PLIF at the Affiliated Hospital of Qingdao University between January 2015 and December 2020 were selected in this study. Besides, variables such as age, gender, BMI, current and past medical history, indications for surgery, surgery-related information, and results of preoperative blood routine tests were also collected from each patient. These patients were divided into injection group and non-injection group according to whether they were injected with human albumin. And they were also divided into training group and validation group, with the ratio of 4:1. Univariate and multivariate logistic regression analyses were performed in the training group to find the independent risk factors. The nomogram was developed based on these independent predictors. In addition, the area under the curve (AUC), the calibration curve and the decision curve analysis (DCA) were drawn in the training and validation groups to evaluate the prediction, calibration and clinical validity of the model. Finally, the nomograms in the training and validation groups and the receiver operating characteristic (ROC) curves of each independent risk factor were drawn to analyze the performance of this model. Results A total of 2482 patients who met our criteria were recruited in this study and 256 (10.31%) patients were injected with human albumin perioperatively. There were 1985 people in the training group and 497 in the validation group. Multivariate logistic regression analysis revealed 5 independent risk factors, including old age, accompanying T2DM, level of preoperative albumin, amount of intraoperative blood loss and fusion stage. We drew nomograms. The AUC of the nomograms in the training group and the validation group were 0.807, 95% CI 0.774–0.840 and 0.859, 95% CI 0.797–0.920, respectively. The calibration curve shows consistency between the prediction and observation results. DCA showed a high net benefit from using nomograms to predict the risk of perioperative injection of human albumin. The AUCs of nomograms in the training and the validation groups were significantly higher than those of five independent risk factors mentioned above (P < 0.001), suggesting that the model is strongly predictive. Conclusion Preoperative low protein, operative stage ≥ 3, a relatively large amount of intraoperative blood loss, old age and history of diabetes were independent predictors of albumin infusion after PLIF. A predictive model for the risk of albumin injection during the perioperative period of PLIF was created using the above 5 predictors, and then validated. The model can be used to assess the risk of albumin injection in patients during the perioperative period of PLIF. The model is highly predictive, so it can be clinically applied to reduce the incidence of perioperative hypoalbuminemia.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lijue Ren ◽  
Cuiying Wei ◽  
Feng Wei ◽  
Ruiting Ma ◽  
Yan Liu ◽  
...  

Abstract Background Hypothyroidism is frequent and has various forms of muscle involvement. We report the diagnosis and treatment of a case of rhabdomyolysis, bilateral osteofascial compartment syndrome (OCS) of the lower extremities, and peroneal nerve injury causing bilateral foot drop in a diabetic patient with hypothyroidism. Case presentation A 66-year-old man with diabetes for 22 years was admitted because of drowsiness, tiredness, facial swelling, and limb twitching for 2 months, and red and swollen lower limb skin for 3 days. Serum creatinine kinase (CK), CK-MB, myoglobin (Mb), blood glucose, and HbA1c were elevated. TSH, thyroid peroxidase antibodies, and antithyroglobulin antibodies were elevated. FT3 and FT4 were low. Urine was dark brown. He was diagnosed with hypothyroidism, rhabdomyolysis, and OCS. CK, CK-MB, and Mb returned to normal after treatment with thyroid hormone, insulin, albumin infusion, ceftriaxone, ulinastatin, and hemofiltration, and the redness and swelling of the lower limbs were relieved, but the patient developed dropping feet. The patient recovered well but had to undergo rehabilitation. Conclusion Hypothyroidism may induce rhabdomyolysis, OCS, and other complications. This case reminds us of the importance of screening for hypothyroidism and strengthens the clinicians’ understanding of the disease.


Author(s):  
Francesco Baratta ◽  
Simona Bartimoccia ◽  
Roberto Carnevale ◽  
Lucia Stefanini ◽  
Francesco Angelico ◽  
...  

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