Administration of Albumin in Hypoalbuminemic PATIENTS.A Prospective,randomized,controlled,pilot Study

Dubois, Marc-Jacques; Orellana-Jimenez, Carlos; Mélot, Christian; Backer, Daniel De; Berré, Jacques; Leeman, Marc; Brimiouille, S; Appoloni, Olivier; Créteur, Jacques; Vincent, Jean‐Louis

doi:10.1097/00003246-200212001-00370

Cited by 2 publications

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“…Consistent with the literature, albumin was a major predictor for POP in aSAH patients (9). Furthermore, other studies have demonstrated that albumin therapy can improve organ function and reduce complications in aSAH patients, potentially leading to better outcomes (25)(26)(27). This finding may be attributed to the fact that low levels of albumin in the blood can cause a decrease in plasma osmotic pressure, leading to pulmonary interstitial edema.…”

Section: Discussionmentioning

confidence: 99%

Development and external validation of a nomogram for predicting postoperative pneumonia in aneurysmal subarachnoid hemorrhage

Jin,

Wang,

Zhang

et al. 2023

Front. Neurol.

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BackgroundPostoperative pneumonia (POP) is a common complication after aneurysmal subarachnoid hemorrhage (aSAH) associated with increased mortality rates, prolonged hospitalization, and high medical costs. It is currently understood that identifying pneumonia early and implementing aggressive treatment can significantly improve patients' outcomes. The primary objective of this study was to explore risk factors and develop a logistic regression model that assesses the risks of POP.MethodsAn internal cohort of 613 inpatients with aSAH who underwent surgery at the Neurosurgical Department of First Affiliated Hospital of Wenzhou Medical University was retrospectively analyzed to develop a nomogram for predicting POP. We assessed the discriminative power, accuracy, and clinical validity of the predictions by using the area under the receiver operating characteristic curve (AUC), the calibration curve, and decision curve analysis (DCA). The final model was validated using an external validation set of 97 samples from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database.ResultsAmong patients in our internal cohort, 15.66% (n = 96/613) of patients had POP. The least absolute shrinkage and selection operator (LASSO) regression analysis identified the Glasgow Coma Scale (GCS), mechanical ventilation time (MVT), albumin, C-reactive protein (CRP), smoking, and delayed cerebral ischemia (DCI) as potential predictors of POP. We then used multivariable logistic regression analysis to evaluate the effects of these predictors and create a final model. Eighty percentage of patients in the internal cohort were randomly assigned to the training set for model development, while the remaining 20% of patients were allocated to the internal validation set. The AUC values for the training, internal, and external validation sets were 0.914, 0.856, and 0.851, and the corresponding Brier scores were 0.084, 0.098, and 0.143, respectively.ConclusionWe found that GCS, MVT, albumin, CRP, smoking, and DCI are independent predictors for the development of POP in patients with aSAH. Overall, our nomogram represents a reliable and convenient approach to predict POP in the patient population.

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Section: Discussionmentioning

confidence: 99%

Development and external validation of a nomogram for predicting postoperative pneumonia in aneurysmal subarachnoid hemorrhage

Jin,

Wang,

Zhang

et al. 2023

Front. Neurol.

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“…[34][35][36][37][38][39] However, these studies focused on specific populations and extrapolation to the general ICU patient may be difficult. Nevertheless, a recent randomized controlled trial of albumin administration in critically ill hypoalbuminemic patients does support a beneficial effect of albumin replacement, 40 and a recent meta-analysis assessed the effects of correcting hypoalbuminemia as reported in 9 prospective studies involving 535 patients. 27 Analysis of dose-dependency in these controlled trials of albumin therapy suggested that complication rates may be reduced when the serum albumin level attained during albumin administration exceeds 30 g/L.…”

Section: Use Of Albumin In Critically Ill Patientsmentioning

confidence: 99%

Should Albumin Be Used to Correct Hypoalbuminemia in the Critically Ill? Yes

Vincent

2003

Transfus Alt Transfus Med

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SUMMARY Hypoalbuminemia is frequent in critically ill patients and is associated with worse outcomes. From the limited clinical data available, it would seem that replenishing low albumin levels in hypoalbuminemic critically ill patients may be of benefit. Nevertheless, deciding exactly which patients to treat and what level of serum albumin to aim for remains uncertain. The results of prospective, randomized controlled trials are urgently needed to provide intensivists with sufficient, high‐grade evidence on which to base decisions regarding albumin use. In the meantime, however, there is no reason to ban the use of albumin in the critically ill patient.

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Administration of Albumin in Hypoalbuminemic PATIENTS.A Prospective,randomized,controlled,pilot Study

Cited by 2 publications

References 0 publications

Development and external validation of a nomogram for predicting postoperative pneumonia in aneurysmal subarachnoid hemorrhage

Development and external validation of a nomogram for predicting postoperative pneumonia in aneurysmal subarachnoid hemorrhage

Should Albumin Be Used to Correct Hypoalbuminemia in the Critically Ill? Yes

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