Association between Albumin Administration and Pulmonary Complications in Patients with Septic Shock: An Analysis Using the MIMIC-IV Database

Abstract

Background: Albumin administration in patients with septic shock has shown potential benefits, but its association with the development of pulmonary complications remains unclear. We aimed to evaluate the impact of albumin administration on acute respiratory distress syndrome development in patients with septic shock. Materials and Methods: We analyzed clinical data from the Medical Information Mart for Intensive Care IV database and included adult patients with septic shock. Propensity score matching was used to balance the covariates between the albumin and non-albumin groups. The primary outcome was the development of moderate-to-severe acute respiratory distress syndrome within 7 days. Survival analysis using the log-rank test compared acute respiratory distress syndrome development rates between the groups. Subgroup analysis was used to evaluate the effect of albumin administration on the primary outcome in various subgroups. Results: Among the 2,132 eligible patients, 1,572 (73.7%) did not receive albumin, whereas 560 (26.3%) received albumin. After propensity score matching, the primary outcome was not significantly different between the two groups (17.5% in the albumin group vs. 16.3% in the non-albumin group; P=0.708). The Kaplan-Meier curve demonstrated no difference in the primary outcome between the groups. Subgroup analysis showed no significant association between albumin administration and increased acute respiratory distress syndrome development rate across various subgroups. Conclusion: No significant difference in acute respiratory distress syndrome development was found between albumin and non-albumin groups of patients with septic shock. Albumin administration in patients with septic shock should be considered when clinically indicated, without undue concerns about acute respiratory distress syndrome development.