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.
  
  
  CONCLUSIONS
  Addition of albumin to a furosemide infusion did not enhance diuresis obtained with furosemide alone in critically ill patients.
authors: Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors: Thitima
authors: T
authors: Doungngern
authors: Yvonne
authors: Y
authors: Huckleberry
authors: John W
authors: JW
authors: Bloom
authors: Brian
authors: B
authors: Erstad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001130:Arizona; D003422:Critical Care / Q000379:methods; D004231:Diuresis / Q000187:drug effects*; D004232:Diuretics / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D005665:Furosemide / Q000008:administration & dosage*; D006801:Humans; D034141:Hypoalbuminemia / Q000188:drug therapy*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012709:Serum Albumin / Q000008:administration & dosage* / Q000494:pharmacology; D055815:Young Adult
chemical_list: D004232:Diuretics; D012709:Serum Albumin; D005665:Furosemide