Effect of albumin on diuretic response to furosemide in patients with hypoalbuminemia

Thitima Doungngern, Yvonne Huckleberry, John W Bloom, Brian L Erstad

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background Albumin is broadly prescribed for critically ill patients although it does not have a mortality benefit over crystalloids. One common use of albumin is to promote diuresis. Objectives To compare urine output in patients treated with furosemide with and without albumin and to assess other variables possibly associated with enhanced diuresis. Methods A retrospective study was conducted on patients in a medical intensive care unit who received furosemide therapy as a continuous infusion with and without 25% albumin for more than 6 hours. Primary end points were urine output and net fluid loss. Results A total of 31 patients were included in the final analysis. Mean urine output in patients treated with furosemide alone did not differ significantly from output in patients treated with furo -semide plus albumin at 6, 24, and 48 hours: mean output, 1119 (SD, 597) mL vs 1201 (SD, 612) mL, P= .56; 4323 (SD, 1717) mL vs 4615 (SD, 1741) mL, P = .42; and 7563 mL (SD, 2766) vs 7432 (SD, 2324) mL, P = .94, respectively. Additionally, net fluid loss did not differ significantly between the 2 groups at 6, 24, and 48 hours. Higher concentrations of serum albumin did not improve urine output. The only independent variable significantly associated with enhanced urine output at 24 and 48 hours was increased fluid intake. Conclusion Addition of albumin to a furosemide infusion did not enhance diuresis obtained with furosemide alone in critically ill patients.

Original languageEnglish (US)
Pages (from-to)280-286
Number of pages7
JournalAmerican Journal of Critical Care
Volume21
Issue number4
DOIs
StatePublished - Jul 1 2012

Fingerprint

Hypoalbuminemia
Furosemide
Diuretics
Albumins
Urine
Diuresis
Critical Illness
Serum Albumin
Intensive Care Units
Retrospective Studies
Mortality

ASJC Scopus subject areas

  • Critical Care

Cite this

Effect of albumin on diuretic response to furosemide in patients with hypoalbuminemia. / Doungngern, Thitima; Huckleberry, Yvonne; Bloom, John W; Erstad, Brian L.

In: American Journal of Critical Care, Vol. 21, No. 4, 01.07.2012, p. 280-286.

Research output: Contribution to journalArticle

@article{37e9b6ed53ed437ea41fcb90befc38f9,
title = "Effect of albumin on diuretic response to furosemide in patients with hypoalbuminemia",
abstract = "Background Albumin is broadly prescribed for critically ill patients although it does not have a mortality benefit over crystalloids. One common use of albumin is to promote diuresis. Objectives To compare urine output in patients treated with furosemide with and without albumin and to assess other variables possibly associated with enhanced diuresis. Methods A retrospective study was conducted on patients in a medical intensive care unit who received furosemide therapy as a continuous infusion with and without 25{\%} albumin for more than 6 hours. Primary end points were urine output and net fluid loss. Results A total of 31 patients were included in the final analysis. Mean urine output in patients treated with furosemide alone did not differ significantly from output in patients treated with furo -semide plus albumin at 6, 24, and 48 hours: mean output, 1119 (SD, 597) mL vs 1201 (SD, 612) mL, P= .56; 4323 (SD, 1717) mL vs 4615 (SD, 1741) mL, P = .42; and 7563 mL (SD, 2766) vs 7432 (SD, 2324) mL, P = .94, respectively. Additionally, net fluid loss did not differ significantly between the 2 groups at 6, 24, and 48 hours. Higher concentrations of serum albumin did not improve urine output. The only independent variable significantly associated with enhanced urine output at 24 and 48 hours was increased fluid intake. Conclusion Addition of albumin to a furosemide infusion did not enhance diuresis obtained with furosemide alone in critically ill patients.",
author = "Thitima Doungngern and Yvonne Huckleberry and Bloom, {John W} and Erstad, {Brian L}",
year = "2012",
month = "7",
day = "1",
doi = "10.4037/ajcc2012999",
language = "English (US)",
volume = "21",
pages = "280--286",
journal = "American Journal of Critical Care",
issn = "1062-3264",
publisher = "American Association of Critical Care Nurses",
number = "4",

}

TY - JOUR

T1 - Effect of albumin on diuretic response to furosemide in patients with hypoalbuminemia

AU - Doungngern, Thitima

AU - Huckleberry, Yvonne

AU - Bloom, John W

AU - Erstad, Brian L

PY - 2012/7/1

Y1 - 2012/7/1

N2 - Background Albumin is broadly prescribed for critically ill patients although it does not have a mortality benefit over crystalloids. One common use of albumin is to promote diuresis. Objectives To compare urine output in patients treated with furosemide with and without albumin and to assess other variables possibly associated with enhanced diuresis. Methods A retrospective study was conducted on patients in a medical intensive care unit who received furosemide therapy as a continuous infusion with and without 25% albumin for more than 6 hours. Primary end points were urine output and net fluid loss. Results A total of 31 patients were included in the final analysis. Mean urine output in patients treated with furosemide alone did not differ significantly from output in patients treated with furo -semide plus albumin at 6, 24, and 48 hours: mean output, 1119 (SD, 597) mL vs 1201 (SD, 612) mL, P= .56; 4323 (SD, 1717) mL vs 4615 (SD, 1741) mL, P = .42; and 7563 mL (SD, 2766) vs 7432 (SD, 2324) mL, P = .94, respectively. Additionally, net fluid loss did not differ significantly between the 2 groups at 6, 24, and 48 hours. Higher concentrations of serum albumin did not improve urine output. The only independent variable significantly associated with enhanced urine output at 24 and 48 hours was increased fluid intake. Conclusion Addition of albumin to a furosemide infusion did not enhance diuresis obtained with furosemide alone in critically ill patients.

AB - Background Albumin is broadly prescribed for critically ill patients although it does not have a mortality benefit over crystalloids. One common use of albumin is to promote diuresis. Objectives To compare urine output in patients treated with furosemide with and without albumin and to assess other variables possibly associated with enhanced diuresis. Methods A retrospective study was conducted on patients in a medical intensive care unit who received furosemide therapy as a continuous infusion with and without 25% albumin for more than 6 hours. Primary end points were urine output and net fluid loss. Results A total of 31 patients were included in the final analysis. Mean urine output in patients treated with furosemide alone did not differ significantly from output in patients treated with furo -semide plus albumin at 6, 24, and 48 hours: mean output, 1119 (SD, 597) mL vs 1201 (SD, 612) mL, P= .56; 4323 (SD, 1717) mL vs 4615 (SD, 1741) mL, P = .42; and 7563 mL (SD, 2766) vs 7432 (SD, 2324) mL, P = .94, respectively. Additionally, net fluid loss did not differ significantly between the 2 groups at 6, 24, and 48 hours. Higher concentrations of serum albumin did not improve urine output. The only independent variable significantly associated with enhanced urine output at 24 and 48 hours was increased fluid intake. Conclusion Addition of albumin to a furosemide infusion did not enhance diuresis obtained with furosemide alone in critically ill patients.

UR - http://www.scopus.com/inward/record.url?scp=84864007383&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84864007383&partnerID=8YFLogxK

U2 - 10.4037/ajcc2012999

DO - 10.4037/ajcc2012999

M3 - Article

VL - 21

SP - 280

EP - 286

JO - American Journal of Critical Care

JF - American Journal of Critical Care

SN - 1062-3264

IS - 4

ER -