Dianne E C van Beek1, Marc H H Königs2, Yvette A M Kuijpers2, Iwan C C van der Horst3, Thomas W L Scheeren4. 1. Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Intensive Care, Maxima Medical Center, Veldhoven, The Netherlands. Electronic address: Dianne.van.Beek@mumc.nl. 2. Department of Intensive Care, Maxima Medical Center, Veldhoven, The Netherlands. 3. Department of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 4. Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Abstract
PURPOSE: To determine the predictive value of serum albumin (SA) at admission to the intensive care unit (ICU) on the cumulative dose of noradrenaline, the fluids administered, the lactate level, and mortality during the first 24 h of ICU admission. METHODS: A total of 100 ICU patients were included. The association between SA and the cumulative dose of noradrenaline was analyzed using logistic regression. For the total amount of fluids administered linear regression, for the lactate level and for 24 h mortality logistic regression was used. Age, gender, patient category, type of surgery, severe sepsis, lactate level, estimated glomerular filtration rate, c-reactive protein level, and the target mean arterial pressure were considered effect modifiers. RESULTS: SA was significantly associated with the dose of noradrenaline (OR 0.92, 95% CI 0.84–0.99, p = 0.028), lower lactate levels (OR 1.14, 95% CI 1.00–1.30, p = 0.049), and with the amount of fluids administered (B -0.02, 95% CI −0.03/−0.00, p = 0.016), but not with mortality (OR 0.95, 95% CI 0.85–1.07, p = 0.41). CONCLUSIONS: SA significantly predicts noradrenaline and fluid requirements as well as the change in lactate level during the first 24 h of ICU admission. Our observations have to be validated in another large cohort.
PURPOSE: To determine the predictive value of serum albumin (SA) at admission to the intensive care unit (ICU) on the cumulative dose of noradrenaline, the fluids administered, the lactate level, and mortality during the first 24 h of ICU admission. METHODS: A total of 100 ICU patients were included. The association between SA and the cumulative dose of noradrenaline was analyzed using logistic regression. For the total amount of fluids administered linear regression, for the lactate level and for 24 h mortality logistic regression was used. Age, gender, patient category, type of surgery, severe sepsis, lactate level, estimated glomerular filtration rate, c-reactive protein level, and the target mean arterial pressure were considered effect modifiers. RESULTS: SA was significantly associated with the dose of noradrenaline (OR 0.92, 95% CI 0.84–0.99, p = 0.028), lower lactate levels (OR 1.14, 95% CI 1.00–1.30, p = 0.049), and with the amount of fluids administered (B -0.02, 95% CI −0.03/−0.00, p = 0.016), but not with mortality (OR 0.95, 95% CI 0.85–1.07, p = 0.41). CONCLUSIONS: SA significantly predicts noradrenaline and fluid requirements as well as the change in lactate level during the first 24 h of ICU admission. Our observations have to be validated in another large cohort.
Authors: Imke H Bartelink; Pierre M Bet; Nicolas Widmer; Monia Guidi; Erik Duijvelaar; Bram Grob; Richard Honeywell; Amanda Evelo; Ivo P E Tielbeek; Sue D Snape; Henrike Hamer; Laurent A Decosterd; Harm Jan Bogaard; Jurjan Aman; Eleonora L Swart Journal: CPT Pharmacometrics Syst Pharmacol Date: 2021-10-24