• Andrea Cortegiani, Giacomo Grasselli, Jennifer Meessen, Alessandra Moscarelli, Mariachiara Ippolito, Fabrizio Turvani, Chiara Maria Bonenti, Stefano Romagnoli, Carlo Alberto Volta, Giacomo Bellani, Antonino Giarratano, Roberto Latini, Antonio Pesenti, and Pietro Caironi.
• Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Department of Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, Italy.
• J Crit Care. 2021 Jun 1; 63: 83-91.

BackgroundThe best fluid replacement strategy and the role of albumin in immunocompromised patients with sepsis is unclear.MethodsWe performed a secondary analysis of immunocompromised patients enrolled in the ALBIOS trial which randomized patients with severe sepsis or septic shock to receive either 20% albumin (target 30 g per liter or more) and crystalloid or crystalloid alone during ICU stay.ResultsOf 1818 patients originally enrolled, 304 (16.4%) were immunocompromised. One-hundred-thirty-nine (45.7%) patients were randomized in the albumin while 165 (54.2%) in the crystalloid group. At 90 days, 69 (49.6%) in the albumin group and 89 (53.9%) in the crystalloids group died (hazard ratio - HR - 0.94; 95% CI 0.69-1.29). No differences were observed with regards to 28-day mortality, SOFA score (and sub-scores), length of stay in the ICU and in the hospital, proportion of patients who had developed acute kidney injury or received renal replacement therapy, duration of mechanical ventilation. Albumin was not independently associated with a higher or lower 90-day mortality (HR 0.979, 95% CI 0.709-1.352) as compared to crystalloid.ConclusionAlbumin replacement during the ICU stay, as compared with crystalloids alone, did not affect clinical outcomes in a cohort of immunocompromised patients with sepsis.Copyright © 2021. Published by Elsevier Inc.

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