Table 2.
Process of care of recipients of 4% versus 20% versus combined (4 + 20%) albumin
| Characteristic | Albumin 4% only | Albumin 20% only |
Combined 4% and 20% |
p value |
|---|---|---|---|---|
| Number (unless indicated, n) | 345 (45) | 155 (20) | 271 (35) | |
| Study Days of care, median (IQR) | 8 [4, 14] | 10 [6, 16] | 17 [10, 26] | <0.001 |
| Plasma albumin, mean (SD), g/L | ||||
| Baseline | 27.3 (7.3) | 24.3 (6.4) | 24.4 (7.1) | <0.001 |
| Average | 26.0 (5.3) | 24.8 (5.5) | 24.5 (5.1) | 0.001 |
| Minimum | 22.4 (6.0) | 20.6 (5.9) | 19.0 (5.3) | <0.001 |
| Albumin, grams, median (IQR) | ||||
| Total grams | 40 [20, 72] | 40 [39, 100] | 149 [90, 264] | <0.001 |
| Mean grams per study day | 5.0 [2.2, 10.0] | 5.7 [3.3, 12.5] | 10.5 [6.5, 19.9] | <0.001 |
| Fresh frozen plasma, n (%) | 121 (35) | 39 (25) | 132 (49) | <0.001 |
| Total mL, median (IQR) | 1,000 [563, 2,128] | 2,094 [671, 3,240] | 1,672 [868, 2,898] | 0.001 |
| Total grams-albumin ◊ | 33 [19, 70] | 69 [22, 107] | 55 [29, 96] | 0.001 |
| Mean grams-albumin per day ◊ | 4.7 [1.7, 11.4] | 5.4 [2.8, 9.9] | 3.1 [1.4, 7.8] | 0.055 |
| Red blood cells, n (%) | 245 (71) | 120 (77) | 246 (91) | <0.001 |
| Total mL, median (IQR) | 598 [0, 1,361] | 795 [253, 1,618] | 1,770 [808, 3,494] | <0.001 |
| Mean mL/day | 199 [0, 322] | 205 [75, 308] | 241 [143, 357] | 0.002 |
| Other blood products, n (%) | ||||
| Platelets | 101 (29) | 43 (28) | 139 (51) | <0.001 |
| Cryoprecipitate | 29 (8.4) | 10 (6.5) | 50 (19) | <0.001 |
| Enteral nutrition | ||||
| Number (%) | 272 (79) | 123 (79) | 240 (89) | 0.004 |
| Mean mL/day, median (IQR) | 792 [486, 1,071] | 840 [584, 1,078] | 936 [638, 1,212] | 0.002 |
| Parenteral nutrition | ||||
| Number (%) | 136 (39) | 76 (49) | 167 (62) | <0.001 |
| Mean mL/day, median (IQR) | 393 [94, 1,145] | 389 [83, 1,225] | 787 [113, 1,395] | 0.10 |
| CRRT fluid, med (IQR), L | ||||
| Average L/day | 24.5 [14.2, 34.9] | 23.9 [15.6, 32.9] | 22.8 [11.2, 37.4] | 0.92 |
| Cumulative total | 155 [83, 321] | 203 [112, 349] | 272 [147, 514] | <0.001 |
| Other IV fluid, median (IQR) | ||||
| Average L/day | 1.6 [1.2, 2.1] | 1.4 [1.0, 1.7] | 1.6 [1.2, 2.0] | <0.001 |
| Cumulative total | 13 [7, 21] | 14 [7, 21] | 25 [15, 40] | <0.001 |
| Fluid balance, median (IQR) | ||||
| Average daily, mL | 243 [–248, 1,050] | −288 [–904, 261] | 88 [–352, 608] | <0.001 |
| Cumulative total, L | 1.9 [–2.4, 6.4] | −2.4 [–9.5, 1.7] | 1.3 [–5.3, 7.4] | <0.001 |
| Urine output, median (IQR) | ||||
| Average daily, mL | 556 [71, 1,670] | 741 [138, 1,404] | 934 [211, 1,817] | 0.02 |
| Cumulative total, L | 4.8 [0.5, 17.8] | 5.5 [1.1, 16.9] | 13.4 [1.9, 34] | <0.001 |
| Total SOFA scores, median (IQR) | ||||
| Mean of averaged scores | 1.8 [1.3, 2.4] | 1.6 [1.3, 2.4] | 1.8 [1.4, 2.4] | 0.566 |
| Maximum of averaged scores | 2.8 [2.2, 3.5] | 2.7 [2.0, 3.3] | 3.0 [2.5, 3.5] | <0.001 |
| Mean of summed scores | 10.0 [7.4, 13.1] | 9.4 [7.3, 13.0] | 10.4 [7.7, 13.7] | 0.179 |
| Maximum of summed scores | 14.4 [12.0, 16.8] | 14.4 [10.8, 16.8] | 15.6 [13.2, 18.0] | <0.001 |
| Cardiovascular SOFA score | ||||
| Mean score, median (IQR) | 2.1 [1.2, 3.7] | 2.2 [1.1, 3.5] | 2.3 [1.5, 3.2] | 0.44 |
| Maximum score, median (IQR) | 4.0 [3.0, 4.0] | 4.0 [3.0, 4.0] | 4.0 [4.0, 4.0] | 0.001 |
| Maximum score, mean (SD) § | 3.5 (1.0) | 3.5 (1.0) | 3.9 (0.5) | <0.001 |
| Respiratory SOFA score | ||||
| Mean score, median (IQR) | 2.9 [2.4, 3.0] | 2.8 [2.0, 3.0] | 2.9 [2.6, 3.0] | 0.12 |
| Maximum score, median (IQR) | 3.0 [3.0, 4.0] | 3.0 [3.0, 4.0] | 3.0 [3.0, 4.0] | 0.007 |
| Maximum score, mean (SD)§ | 3.2 (0.6) | 3.1 (0.8) | 3.3 (0.6) | 0.001 |
| Biochemistry (mean), median (IQR) | ||||
| pH | 7.39 [7.33, 7.43] | 7.40 [7.36, 7.43] | 7.41 [7.37, 7.44] | <0.001 |
| Potassium, mmol/L | 4.3 [4.1, 4.6] | 4.2 [4.0, 4.4] | 4.3 [4.1, 4.5] | 0.015 |
| BUN, mmol/L†† | 14.0 [10.7, 19.1] | 14.2 [11.0, 19.2] | 14.8 [11.0, 19.6] | 0.500 |
| Continuous RRT filters, median (IQR) | ||||
| Average filters per day‡ | 0.8 [0.5, 1.0] | 1.0 [0.7, 1.3] | 0.9 [0.6, 1.3] | 0.001 |
| Total filters | 3.0 [2.0, 6.0] | 5.0 [3.0, 8.0] | 6.0 [3.0, 11.0] | <0.001 |
| Continuous RRT vascular access, median [IQR] | ||||
| Average Vascaths per day | 0.1 [0.1, 0.3] | 0.1 [0.1, 0.2] | 0.1 [0.1, 0.2] | <0.001 |
| Total Vascaths | 1.0 [1.0, 1.0] | 1.0 [1.0, 2.0] | 1.0 [1.0, 2.0] | <0.001 |
BUN, blood urea nitrogen; SOFA, sequential organ failure assessment; IQR, interquartile range; RRT, renal replacement therapy.
◊
Refers to the albumin content of fresh frozen plasma.
§
Cohort mean of the maximum cardiovascular/respiratory SOFA score value per subject per day, included to reflect direction of association.
††
To convert the values for BUN to milligrammes per decilitre, divide by 0.357.
‡
Displayed in online suppl. Figure 3 of Supplementary Material 1.