(1530) Effects of Albumin Versus Crystalloid in Postoperative Cardiac Surgery

Introduction: In cardiac surgery patients, there is a paucity of data to guide fluid resuscitation. Albumin continues to be used routinely in cardiac surgery postoperatively despite limited data for improved outcomes. The aim of this study was to evaluate the rate of acute kidney injury (AKI) in cardiothoracic surgery patients receiving albumin versus crystalloids for resuscitation postoperatively.

Methods: This case-controlled, retrospective chart review included patients 18 years and older and had undergone cardiac surgery between June 2019 and December 2023. Patients were excluded if they were in the ICU for less than 24 hours. The primary outcome was the rate of AKI. Secondary outcomes included the rate of prolonged mechanical ventilation (defined as greater than 24 hours), blood transfusion, bleeding, arrythmias, stroke, and in-hospital mortality.

Results: 179 patients were included in the analysis, of which 87 were assigned to the albumin cohort and 92 were assigned to non-albumin cohort. There was no difference in the rate of AKI (20.69% vs 19.57%, p = 0.851). Patients in the albumin cohort had a longer duration of mechanical ventilation (19.54% vs 5.43%, p = 0.004) and higher rate of blood transfusion (57.47% vs 21.74%, p < 0.001). Overall, there was no difference in the rate of bleeding (8.05% vs 5.43%, p = 0.485), arrhythmias (25.29% vs 21.74%, p = 0.576), stroke (5.57% vs 2.17%, p = 0.218), and in-hospital mortality (3.45% vs 1.09%, p = 0.285).

Conclusions: Administration of albumin for fluid resuscitation in cardiothoracic surgery patients was not associated with reduced risk of postoperative AKI.