(1541) Serving up Albumin in Patients With Sepsis/Septic Shock in the Surgical Intensive Care Unit

Introduction: The objective of this study is to evaluate the use of albumin in patients with sepsis/septic shock.

Methods: This study was IRB approved, retrospective, chart review from Jan 2021 to March 2024. SICU patients were included if they were adult with sepsis and septic shock. Patients were allocated in two cohorts: first cohort was patients who received albumin in addition to balanced crystalloids and the second cohort was patients who received balanced crystalloids alone. The primary outcome was 30-day mortality. Secondary outcomes included hospital and SICU length of stay (LOS), albumin changes, days septic, total amount of fluid therapy given; days on vasopressors, heart rate and mean arterial pressure, and the incidence of rapid ventricular rate or atrial fibrillation, pulmonary edema, peripheral edema, increased respiratory demand (defined by FIO2 vent setting increase) between the 2 groups.

Results: 151 patients were included in the study; 65 received albumin and 86 did not receive albumin. APACHE II score was 24 for albumin patients and 15 for non albumin patients. 30-day mortality was 55% (24 patients) in the albumin group vs 41% (20 patients) in the non-albumin group (p=0.186). The hospital LOS was 28 for albumin patients and 14 for non albumin patients (p=0.001). SICU LOS was 12 days in albumin group vs 5 days in the non-albumin group (p= < 0.001). The time to resolution of septic shock was 10 days in both groups. Pulmonary edema occurred in 5 (11%) of patients in the albumin group and 13 (26%) of patients in the non-albumin group (p=0.064). No differences in peripheral edema were seen between both groups. Increase in respiratory demand requirements defined by increased FIO2 requirements were seen in 2 (4.4%) of patients in the albumin group and 13 (26%) of patients in the non-albumin group (p=0.004).

Conclusions: Our study reveals that patients who received albumin and presented with septic shock had a greater baseline severity of illness based on APACHE II score, however, no difference in 30 day mortality was detected compared to patients who did not receive albumin. Albumin use at our institution showed a trend toward decreased pulmonary edema in septic shock patients and decreased FIO2 requirements compared to patients who did not receive albumin.