Co-administration of albumin and loop diuretic may be associated with reduced mortality in septic shock patients: A retrospective study with PSM analysis

Background: This study aimed to investigate the potential impact of administering albumin and loop diuretics together on in-hospital mortality in septic shock patients.

Methods: Data from the MIMIC-IV database was used for a retrospective cohort study analyzing 3,298 adult septic shock patients. The Cox proportional hazards model and propensity score matching (PSM) were utilized to assess the relationship between loop diuretic administration and in-hospital mortality.

Results: The study found that septic shock patients who received albumin in combination with loop diuretic had a significantly lower in-hospital mortality rate compared to those who received albumin alone (19.4 % vs 33.1 %, p < 0.001). Administering diuretics after albumin infusion was associated with lower mortality rates. Optimal furosemide dosages of 10 to 40 mg daily were linked to the lowest mortality rates.

Conclusion: Co-administering albumin and loop diuretics in septic shock patients receiving high-dose crystalloids may be associated with reduced in-hospital mortality. Further investigation through a prospective randomized controlled trial is recommended to validate these findings.