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Association between albumin administration and survival in cardiac surgery: a retrospective cohort study

Albumin is a plasma volume expander used in surgical and intensive care.

Some studies suggest that albumin may have additional anti-inflammatory and antioxidant benefits during cardiac surgery. However, potential adverse effects include acute kidney injury in patients with underlying kidney dysfunction.

There is currently evidence showing the superiority of albumin versus crystalloids in preserving platelet counts during on-pump surgery, but it is not clear if its use leads to improved clinical outcomes in this specific setting.

In this retrospective observational study, 6188 patients undergoing on-pump cardiac surgery for isolated valve, isolated coronary artery bypass grafting, or two or more procedures requiring cardiopulmonary bypass, were evaluated for survival and renal outcomes according to the type of fluid therapy administered.

Propensity score matching was used for controlling for confounding factors. Compared with patients who received crystalloid solutions alone, patients who received 5% albumin concomitantly showed decreased risk of in-hospital mortality (2.3% versus 3.3%) and a lower all-cause 30-day hospital readmission rate (10% versus 14%). No differences were seen in overall major morbidity or severity of acute kidney injury.

These data support the use of albumin in cardiac surgery when colloids are indicated, but a causal effect between the use of this colloid and survival benefits cannot be established.