A randomized, controlled trial of furosemide with or without albumin in hypoproteinemic patients with acute lung injury*

  title={A randomized, controlled trial of furosemide with or without albumin in hypoproteinemic patients with acute lung injury*},
  author={Greg S. Martin and Marc Moss and Arthur P. Wheeler and Meredith Mealer and John A. Morris and Gordon R. Bernard},
  journal={Critical Care Medicine},
Objective:Hypoproteinemia is a common condition in critically ill patients, associated with the development of acute lung injury and acute respiratory distress syndrome and subsequent worse clinical outcomes. Albumin with furosemide benefits lung physiology in hypoproteinemic patients with acute lung injury/acute respiratory distress syndrome, but the independent pharmacologic effects of these drugs are unknown. Design:Randomized, double-blinded, placebo-controlled multicentered trial. Setting… 
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Effect of albumin on diuretic response to furosemide in patients with hypoalbuminemia.
Addition of albumin to a furosemide infusion did not enhance diuresis obtained with furoSemide alone in critically ill patients, and higher concentrations of serum albumin did not improve urine output.
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A positive fluid balance after AKI was strongly associated with mortality and post-AKI diuretic therapy was associated with 60-day patient survival in FACTT patients with ALI; this effect may be mediated by fluid balance.
Nonventilatory Interventions in the Acute Respiratory Distress Syndrome
This review focuses on the nonventlilatory strategies and includes fluid restriction, exogenous surfactant, inhaled nitric oxide, manipulation of production, or administration of eicosanoids, neuromuscular blocking agents, prone position ventilation, glucocorticoids, extracorporeal membrane oxygenation, and administration of beta-agonists.


Albumin and furosemide therapy in hypoproteinemic patients with acute lung injury*
Albumin and furosemide therapy improves fluid balance, oxygenation, and hemodynamics in hypoproteinemic patients with acute lung injury, with favorable trends in measures of intensive care.
Low-dose inhaled nitric oxide in patients with acute lung injury: a randomized controlled trial.
Inhaled nitric oxide at a dose of 5 ppm in patients with acute lung injury not due to sepsis and without evidence of nonpulmonary organ system dysfunction results in short-term oxygenation improvements but has no substantial impact on the duration of ventilatory support or mortality.
Continuous dose furosemide as a therapeutic approach to acute respiratory distress syndrome (ARDS).
Continuous dose furosemide therapy improves LIS, PO2/FIO2, and Qs/Qt and decreases PEEP requirements in this oleic acid model of ARDS.
Hypoproteinemia predicts acute respiratory distress syndrome development, weight gain, and death in patients with sepsis
Hypoproteinemia is significantly correlated with fluid retention and weight gain, development of ARDS and poor respiratory outcome, and mortality in patients with sepsis and prospective, randomized trials of serum protein manipulation are needed.
Extravascular lung water in patients with severe sepsis: a prospective cohort study
More than half of the patients with severe sepsis but without ARDS had increased EVLW, possibly representing subclinical lung injury, and this correlated moderately with the severity of lung injury but did not account for all respiratory derangements.
Treatment of adult respiratory distress syndrome with diuretics, dialysis, and positive end‐expiratory pressure
  • R. Bone
  • Medicine
    Critical care medicine
  • 1978
A new treatment protocol has been proposed that uses high positive end-expiratory pressure early in the course of adult respiratory distress syndrome; mortality using this technique was 20% and the difference in survival may be more apparent than real.
Albumin influences total plasma antioxidant capacity favorably in patients with acute lung injury*
In patients with acute lung injury, albumin administration favorably influences plasma thiol-dependent antioxidant status as well as levels of protein oxidative damage.
Improved outcome based on fluid management in critically ill patients requiring pulmonary artery catheterization.
A lower positive fluid balance, especially in patients with pulmonary edema regardless of cause, is associated with reduced EVLW, ventilator-days, and ICU days, as well as time on mechanical ventilation and time in the intensive care unit (ICU), in critically ill patients requiring pulmonary artery catheterization.
Epidemiology and outcome of acute lung injury in European intensive care units. Results from the ALIVE study.
While the mortality of ARDS remains high, that of mild ALI is twice as low, confirming the grading of severity between the two forms of the syndrome.
Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis.
In patients with cirrhosis and spontaneous bacterial peritonitis, treatment with intravenous albumin in addition to an antibiotic reduces the incidence of renal impairment and death in comparison with treatment with an antibiotic alone.