Impact of Hyperoncotic Albumin on Duration of Vasopressor Support inSeptic Shock: A PropensityScore–Matched Analysis

Alexander H. Flannery, Gary D. Owen, Angel Coz, Melissa L. Thompson Bastin, Kripa Patel

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: While albumin has not been shown to reduce mortality in sepsis and septic shock, a tertiary analysis of a large trial suggested that it may reduce the duration of vasopressor use in septic shock. Objective: We sought to test if 25% albumin administration was associated with reduced cumulative vasopressor use in septic shock in a real-world setting. Methods: This was a retrospective, propensity score–matched cohort study of septic shock in which patients receiving albumin were compared with a matched cohort of those not receiving albumin. The primary outcome was days alive and free of vasopressors. Results: The matched cohort included 335 patients who received albumin and 335 who did not. The days alive and free of vasopressors were similar between the albumin and no albumin groups: 17.4 (0-24.8) versus 19.4 (0-25.3); P = 0.160. Similarly, in-hospital mortality was no different between groups (46.9% vs 44.8%; P = 0.587). Receipt of albumin was associated with fewer ventilator-free and intensive care unit (ICU)-free days: 0 (0-19) versus 11 (0-23), P = 0.007, and 0 (0-18) versus 10.6 (0-22.1), P = 0.002, respectively. Conclusion and Relevance: Albumin use in septic shock was not associated with additional days alive and free of vasopressors or in-hospital mortality. The finding of fewer ventilator- and ICU-free days may reflect selection of patients who were critically ill for longer periods of time before or after albumin administration. Additional study is needed to clarify the impact that timing may have on the effectiveness of albumin in septic shock.

Original languageEnglish
Pages (from-to)584-591
Number of pages8
JournalAnnals of Pharmacotherapy
Volume55
Issue number5
DOIs
StatePublished - May 2021

Bibliographical note

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The project described was supported by the NIH National Center for Advancing Translational Sciences through grant number UL1TR001998. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The project described was supported by the NIH National Center for Advancing Translational Sciences through grant number UL1TR001998. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Publisher Copyright:
© The Author(s) 2020.

Keywords

  • albumin
  • critical care
  • mortality
  • sepsis
  • septic shock
  • vasopressor

ASJC Scopus subject areas

  • Pharmacology (medical)

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