Michael Long, Jr., PharmD
PGY2 Emergency Medicine Pharmacy Resident
Indiana University Health
Hawkinsville, Georgia
Disclosure information not submitted.
Eric Shaw, PhD
Professor
Mercer University School of Medicine, United States
Disclosure information not submitted.
Stephanie Lesslie, PharmD, BCPS, BCCCP
Clinical Pharmacist, Critical Care Medicine
Memorial Health University Medical Center, United States
Disclosure information not submitted.
Title: Albumin With Furosemide vs. Furosemide Alone for De-Resuscitation Following Sepsis or Septic Shock
Introduction: Fluid therapy is a common treatment in the management of critically ill patients. While fluids are important in sepsis and septic shock management, fluid overload has been associated with poor outcomes in critically ill adults. This study evaluated the use of albumin to augment furosemide in de-resuscitation of the hypoalbuminemic critically ill patient as conflicting data have been published regarding its use in this patient population.
Methods: Adult patients admitted to the intensive care unit from July 1, 2015 to June 30, 2020 with hypoalbuminemia as defined as serum albumin < 2.5 g/dL and administered furosemide with albumin or furosemide alone for de-resuscitation following sepsis or septic shock were included. The primary outcome evaluated for this study was the change in net fluid balance after 5 days of de-resuscitation.
Results: Eighty patients were included in this IRB-approved study. This study found that the addition of albumin to furosemide did not provide a significant difference in the change in net fluid balance after 5 days, with the albumin group having a mean + SD of 6,316.6 + 5,632.6 mL vs. 6,137.0 + 5,977.5 mL in the furosemide only group (p = 0.890). This study also found no statistically significant difference in cumulative urine output or net fluid balance at time points 6, 12, 24, 48, 72, 96, and 120 hours, renal replacement therapy, ICU length of stay, mortality, and duration of mechanical ventilation.
Conclusions: The addition of albumin to furosemide for de-resuscitation following sepsis or septic shock in patients with hypoalbuminemia was not associated with an improvement on net fluid balance. There were no differences in secondary outcomes between groups.