Impact of albumin compared to saline on organ function and mortality of patients with severe sepsis.
Intensive Care Med
; 37(1): 86-96, 2011 Jan.
Article
em En
| MEDLINE
| ID: mdl-20924555
ABSTRACT
PURPOSE:
To determine the effect of random assignment to fluid resuscitation with albumin or saline on organ function and mortality in patients with severe sepsis.METHODS:
Pre-defined subgroup analysis of a randomized controlled trial conducted in the intensive care units of 16 hospitals in Australia and New Zealand.RESULTS:
Of 1,218 patients with severe sepsis at baseline, 603 and 615 were assigned to receive albumin and saline, respectively. The two groups had similar baseline characteristics. During the first 7 days mean arterial pressure was similar in the two groups, but patients assigned albumin had a lower heart rate on days 1 and 3 (p = 0.002 and p = 0.03, respectively) and a higher central venous pressure on days 1-3 (p < 0.005 each day). There was no difference in the renal or total Sequential Organ Failure Assessment score of the two groups; 113/603 (18.7%) of patients assigned albumin were treated with renal replacement therapy compared to 112/615 (18.2%) assigned saline (p = 0.98). The unadjusted relative risk of death for albumin versus saline was 0.87 [95% confidence interval (CI) 0.74-1.02] for patients with severe sepsis and 1.05 (0.94-1.17) for patients without severe sepsis (p = 0.06 for heterogeneity). From multivariate logistic regression analysis adjusting for baseline factors in patients with complete baseline data (919/1,218, 75.5%), the adjusted odds ratio for death for albumin versus saline was 0.71 (95% CI 0.52-0.97; p = 0.03).CONCLUSIONS:
Administration of albumin compared to saline did not impair renal or other organ function and may have decreased the risk of death.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cloreto de Sódio
/
Sepse
/
Albuminas
/
Hidratação
Tipo de estudo:
Clinical_trials
/
Etiology_studies
Limite:
Female
/
Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article