Efficacy of albumin and loop diuretic Co-administration in reducing mortality among septic patients with hypoalbuminemia.

BACKGROUND

Hypoalbuminemia in septic patients is a known prognostic factor for poor outcomes, yet the optimal therapeutic interventions remain unclear. This study aimed to evaluate the effect of the co-administration of albumin and loop diuretics on in-hospital mortality among septic patients with hypoalbuminemia.

METHODS

This retrospective cohort study utilized data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, analyzing 3373 adult septic patients diagnosed with hypoalbuminemia. To control for potential confounding factors, Cox proportional hazard models and propensity score matching (PSM) were employed. The primary outcome was in-hospital mortality, and secondary outcomes included the effects of different dosages of loop diuretics.

RESULTS

The results demonstrated that septic patients with hypoalbuminemia who received a combination of albumin and loop diuretics had a significantly lower in-hospital mortality rate compared to those treated with albumin alone (25.5 % vs. 36.5 %, p < 0.001). The timing of diuretic administration, specifically after albumin infusion, was linked to further reductions in mortality. Notably, the administration of furosemide at dosages between 10 mg and 40 mg per day was associated with the lowest mortality rates.

CONCLUSION

In septic patients with hypoalbuminemia, co-administration of albumin and loop diuretics is associated with a substantial reduction in in-hospital mortality, especially when loop diuretics are administered following albumin infusion. These findings suggest a potential treatment strategy that merits validation through future prospective randomized controlled trials.