Abstract
Purpose: To justify the use of albumin infusion in patients in post-surgery cardiac intensive care unit.
 Methods: All patients who were hemodynamically stable before the operation and admitted into the surgical intensive care unit following coronary artery bypass, cardiopulmonary bypass, or aortic surgery, had no excessive postoperative bleeding and not on diuretic treatment, were included in the analysis. A total of 1998 patients were divided into two cohorts, viz, the first group was placed on albumin infusion (n = 999) while the second group received normal saline infusion (n = 999). Data were obtained from DICOM files of patients and records of pharmacy. Wilcoxon test or two-tailed paired t-test followed by Tukey post-hoc tests were performed for statistical analysis at 95 % of confidence level.
 Results: Albumin and normal saline administration did not decrease the duration of mechanical ventilation, incidence of mechanical ventilation, need for blood transfusion, and length of hospital stay (p > 0.05). Albumin infusion decreased the need for fresh frozen plasma transfusion from 85 to 67, reduced mortality (p = 0.0005, q = 3.959), lowered serum lactate level (p < 0.0001, q = 43.853), but increased cardiac index (p < 0.0001, q = 12.192) as well as financial burden (p < 0.0001, q = 95.158) for the patients, compared to normal saline group.
 Conclusion: In view of the foregoing, it is recommended that the use of restriction of albumin resuscitation in surgical intensive care unit should be restricted in this subset of patients evluated in this study.
Highlights
Low serum albumin levels commonly occur in patients following cardiac surgery [1] and are associated with poorer outcomes [2]
The primary aim of the analysis was to evaluate the effectiveness of albumin administration for resuscitation on mortality, freshly frozen plasma transfusions, lactate level, and cardiac index in post-operative patients within the cardiac intensive care unit
All patients who had been admitted into the surgical intensive care unit (SICU) in the First Hospital of Jilin University from 16 January 2016 to 1 March 2017 following coronary artery bypass, cardiopulmonary bypass, or aortic surgery procedures were included in the study cohort
Summary
Low serum albumin levels commonly occur in patients following cardiac surgery [1] and are associated with poorer outcomes [2]. In such conditions, plasma volume expansion is often necessary [3]. There is no clear guideline regarding intravenous infusion for resuscitation [4] but albumin solution is the first choice of the surgeon as plasma expander before or after cardiac surgery in critically ill patients [5]. The primary aim of the analysis was to evaluate the effectiveness of albumin administration for resuscitation on mortality, freshly frozen plasma transfusions, lactate level, and cardiac index in post-operative patients within the cardiac intensive care unit. The secondary endpoint of the study was to compare incidences and time of mechanical ventilation, requirements of blood transfusion, length of hospital stay, and cost of albumin and normal saline administration in resuscitation in two cohorts
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