Does serum albumin correlate with measures of volume status in septic ICU patients?
CCCF ePoster library. Pop P. Oct 26, 2015; 117296; P34 Disclosure(s): The data from this study was provided by a pilot study which was funded by Regional Medical Associates, Postgraduate Medicine Program McMaster University, and the Division of Nephrology McMaster University. A follow up study will be completed and is funded by the CIHR Health Professional Student Research Award.
Paula Pop
Paula Pop
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P34


Topic: Retrospective or Prospective Cohort Study


Does serum albumin correlate with measures of volume status in septic ICU patients?



Paula Pop, B. Rochwerg, J. Cheung, C. Ribic, T. Wilkieson, P. Margetts, A. Gangji

Medicine, McMaster University, Hamilton, Canada | Department of Medicine, McMaster University, Hamilton, Canada | Department of Medicine, McMaster University, Hamilton, Canada | Department of Medicine and Division of Nephrology, McMaster University, Hamilton, Canada | Division of Nephrology, McMaster University, Hamilton, Canada | Department of Medicine and Division of Nephrology, McMaster University, Hamilton, Canada | Department of Medicine and Division of Nephrology, McMaster University, Hamilton, Canada

Introduction:

Current methods for assessing volume status in the intensive care unit (ICU) such as jugular venous pressure (JVP) measurements, passive leg raise, and pulse pressure variation are imprecise and unreliable. Furthermore, current techniques such as central venous pressure (CVP) monitoring and Swann-Ganz catheter are invasive. Bioelectric impedance analysis (BIA) represents an alternative tool for measuring volume status in the ICU. BIA is a point of care device which determines volume status by distributing a small electrical current through the body and measuring its resistance and reactance. Albumin is an important plasma protein in maintaining serum oncotic pressure and regulating fluid balance. Furthermore, it acts as an acute phase reactant which falls during sepsis. BIA represents a novel method of assessing volume status in the ICU. It remains unknown what effect albumin levels have on BIA measures or other markers of volume status.



Objectives:

It is important to understand the correlation of serum albumin levels with BIA measurements in order to better appreciate the applicability of BIA as a marker for fluid status in septic ICU patients. The objective of this study is to assess the correlation between serum albumin and other markers of volume status including BIA phase angle and vector length.



Methods: BIA measures were performed on septic ICU patients in a single center observational study. Herein we present a post-hoc exploratory analysis of the prospectively collected data. We examined the correlation between serum albumin levels and BIA measures and other clinical measures of volume status including serum N-BNP, CVP, and edema score. The statistical analysis used to determined correlation was based on Spearman’s Rho.



Results: Lab values were available from 48 patients. The mean serum albumin level was 28 g/L (SD 5.17). Only edema score was significantly correlated with serum albumin level. The edema score inversely correlated with albumin level indicating a negative relationship between the two variables with a P value of 0.012. No other statistically significant relationships were found between serum albumin and other markers of volume status. Furthermore, edema score did correlate with BIA vector length, serum N-BNP, and CVP.

Conclusion: Serum albumin may represent an important marker of volume status. This is evident given the negative correlation seen with edema score. No other significant relationships were found however, this may be a reflection of the small sample size and a failure to capture other markers of inflammation which may additionally influence albumin levels. The results of this post hoc analysis are unable to clearly identify whether serum albumin is a marker of volume status or inflammation indicating that albumin should be studied in a broader context.

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