5. EVALUATING THE EFFICACY OF COMBINED FUROSEMIDE AND ALBUMIN THERAPY DURING THE EVACUATION PHASE IN SEPTIC SHOCK PATIENTS
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Abstract
Objective: To evaluate the efficacy of combining Furosemide and Albumin versus Furosemide alone during the evacuation phase in patients with septic shock.
Materials and methods: A prospective, randomized controlled trial was conducted on 44 patients with septic shock during the fluid evacuation phase, admitted to the Anesthesia and Surgical Intensive Care Center, Viet Duc University Hospital from January to June 2025. Patients were randomly assigned to two groups: group 1 received Furosemide in combination with Albumin, while group 2 received Furosemide alone. Parameters assessed over 24 hours post-intervention included urine output, fluid balance, PaO2/FiO2 ratio, and hemodynamic variables.
Results: Group 1 demonstrated significantly higher mean urine output compared to Group 2 (4532.73 ± 946.14 ml vs. 3781.82 ± 925.63 ml; p = 0.011), a more negative fluid balance (p = 0.015), and a higher proportion of patients achieving negative fluid balance (100% vs. 72.7%; p = 0.021). Improvement in PaO2/FiO2 was also significantly greater in group 1 (p < 0.001). The incidence of hypotension was lower in group 1 (9.1% vs. 18.2%), though the difference was not statistically significant.
Conclusion: The combination of Furosemide and Albumin during the evacuation phase increases urine output, promotes negative fluid balance, improves gas exchange, and reduces the incidence of hypotension compared to Furosemide alone in patients with septic shock.
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References
[2] Pfortmueller C.A et al. Fluid accumulation syndrome in sepsis and septic shock: pathophysiology, relevance and treatment-a comprehensive review. Annals of Intensive Care, 2024, 14: 115.
[3] Manu LNG Malbrain, Greg Martin, Marlies Ostermann. Everything you need to know about deresuscitation. Intensive Care Medicine, 2022, 48: 1781-1786.
[4] Greg S Martin et al. A randomized, controlled trial of Furosemide with or without Albumin in hypoproteinemic patients with acute lung injury. Critical Care Medicine, 2005, 33: 1681-1687.
[5] Tao Han Lee et al. Diuretic effect of co-administration of Furosemide and Albumin in comparison to Furosemide therapy alone: An updated systematic review and meta-analysis. PLoS ONE, 2021, 16: e0260312.
[6] Ines Lakbar et al. Septic shock: incidence, mortality and hospital readmission rates in French intensive care units from 2014 to 2018. Anaesthesia, Critical Care & Pain Medicine, 2022, 41: 101082.
[7] Ata Mahmoodpoor et al. Efficacy of Furosemide - Albumin compared with Furosemide in critically ill hypoalbuminemia patients admitted to intensive care unit: a prospective randomized clinical trial. DARU Journal of Pharmaceutical Sciences, 2020, 28: 263-269.
[8] Simon J.W Oczkowski et al. Furosemide and Albumin for Diuresis of Edema (FADE): A parallel-group, blinded, pilot randomized controlled trial. Journal of Critical Care, 2018, 48: 462-467.