Early high-volume resuscitation with crystalloid solution combined with albumin improves survival of critically ill patients: A retrospective analysis from MIMIC-IV database

作者全名：Qin, Yalan; Liu, Yinzhou; Tang, Binfei; Cao, Yunxing; Huang, Wenqi; Zhang, An

作者地址：[Qin, Yalan; Liu, Yinzhou; Tang, Binfei; Cao, Yunxing; Huang, Wenqi; Zhang, An] Chongqing Med Univ, Affiliated Hosp 2, Dept Crit Care Med, 76 Linjiang Rd, Chongqing 400016, Peoples R China

通信作者：Zhang, A (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Crit Care Med, 76 Linjiang Rd, Chongqing 400016, Peoples R China.

来源：BURNS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001218430300001

JCR分区：Q1

影响因子：3.2

年份：2024

卷号：50

期号：4

开始页：893

结束页：902

文献类型：Article

关键词：Volume resuscitation; Albumin; Crystalloids; Critical care

摘要：Background: Volume resuscitation is often required in critically ill patients. However, we have no clear consensus on the choice between crystalloid solution and colloidal solution. This study aimed to explore the effect of albumin administration in massive fluid resuscitation. Methods: This was a retrospective cohort study based on the Medical Information Mart for Intensive Care IV (MIMIC-IV) database (2008 and 2019). The prognosis of patients receiving albumin in combination with crystalloids and those receiving crystalloids alone was compared to assess the benefits of albumin in fluid resuscitation. Results: 4426 patients received crystalloids alone (crystalloids group), 692 patients received albumin in combination with crystalloids within the first 24 h of initiation of crystalloids (early albumin combination group), and 382 patients received albumin after the first 24 h (late albumin combination group). Patients in early albumin combination group were more severe than those in Crystalloids group. Nevertheless, we found no statistically significant difference in mortality between the two groups. Multivariate logistic regression analysis using the propensity-score matched cohort showed that the 28-day and 60-day mortality in the early albumin combination group were lower than those in the crystalloids group (odds ratio: 0.64 [95% CI 0.50-0.82; P < 0.001] and 0.71 [95% CI 0.56-0.90; P = 0.004], respectively. Patients in early albumin combination group lived, on average, 1.16 days (95% CI 0.33-2.00; P < 0.01) and 3.3 days (95% CI 1.15-5.44; P < 0.01) longer than the crystalloids group during 28-day follow-up and 60-day follow-up. Conclusion: Administration of albumin within 24 h after the initiation of crystalloids was associated with a lower mortality and a longer restricted mean survival time during 28-day follow-up and 60-day follow-up compared with crystalloid infusion alone. However, administration of albumin 24 h after the initiation of crystalloids was not associated with better prognosis compared to crystalloid infusion alone. (c) 2024 Elsevier Ltd and ISBI. All rights reserved.

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