Early human albumin infusion was associated with 28-day mortality in patients with acute respiratory failure and hypoalbuminaemia in the intensive care unit: a retrospective study of the MIMIC-IV database

Background

To investigate the relationship between different timing of human albumin infusion and mortality in patients with acute respiratory failure in an Intensive Care Unit (ICU).

Methods

This cohort study utilized data from the Medical Information Mart for Intensive Care (MIMIC-IV 2.0) database. Patients were categorized into two groups, early human albumin infusion (infusion within 72 h after ICU admission) and late human albumin infusion (infusion more than 72 h after ICU admission), irrespective of dosage or colloid osmotic pressure. 28-day mortality and independent risk factors of mortality were measured.

Results

A total of 1118 patients with acute respiratory failure and hypoalbuminaemia were included in the analysis, with 471 patients in the early albumin infusion group and 647 patients in the late albumin infusion group. After PSM, 451 patients were included in each group. Kaplan–Meier analysis revealed that 28-day mortality was statistically significantly higher in the early albumin infusion group compared to the late albumin infusion group. Additionally, stratified analysis by albumin levels showed that 28-day mortality was statistically significantly higher in the early infusion group than in the late infusion group for patients with albumin levels less than 30 g/L.

Conclusion

The 28-day mortality of patients with acute respiratory failure who received early human albumin infusion in the ICU was higher than that of patients who received late human albumin infusion. Early albumin infusion was not associated with an improvement in the survival rate among patients with acute respiratory failure in the ICU.