Data of 63 pediatric patients with
septic shock admitted to Department of
Critical Care Medicine of Hebei Provincial Children's Hospital were collected and retrospectively analyzed. The patients were divided into two groups according to whether they received
albumin for volume
resuscitation within 1 day after admission or not. The patients in observation group (
crystalloid +
albumin group, n=33) received
normal saline (20 mL/kg) followed by 1 g/kg
albumin 30 minutes after admission, and those in control group (
crystalloid group,
n=30) received only
normal saline (20 mL/kg) 30 minutes after admission, and
normal saline resuscitation was continued according to the effect of
fluid therapy. Anti-
infection and vasoactive drugs strategies were the same in both groups. The first-hour infusion volume, time showing stable hemodynamics, the incidence of
pulmonary edema, and blood
lactate levels at 0, 6, 12 hours after achieving the goals were compared, and blood
lactate clearance rates were calculated.
RESULTS: The first-hour infusion volume time in the observation group was lower than that in control group (41.56 ±10.50 mL vs. 57.24±7.54 mL, t=4.596, P=0.000), and time showing stable hemodynamics was shorter than that in control group but without statistically significant difference (219.87±70.23 minutes vs. 287.10±67.00 minutes, t=2.047, P=0.360). The incidence of
pulmonary edema in observation group was slightly lower than that in control group [6.1% (2/33) vs. 10.0% (3/30), χ2=2.272, P=0.259]. The
lactic acid levels were decreased gradually along with rehabilitation time, while
lactate clearance rate was increased in both groups. At 0 hour and 6 hours after
resuscitation, the
lactate level in the observation group was significantly lower than that in control group (0 hour: 3.65±2.84 mmol/L vs. 5.72±2.11 mmol/L, t=1.940, P=0.046; 6 hours: 2.12±1.21 mmol/L vs. 4.09±1.45 mmol/L, t=2.892, P=0.005), while the
lactate clearance rate was significantly increased compared with control group [0 hour: (0.38±0.15)% vs. (0.18±0.09)%, t=1.447, P=0.018; 6 hours: (0.62±0.14)% vs. (0.51±0.11)%, t=1.920, P=0.047]. However, at 12 hours after
resuscitation, there were no statistically significant differences in the
lactic acid level (1.46±0.39 mmol/L vs. 1.54±1.90 mmol/L, t=0.450, P=0.072) and the
lactate clearance rate [(0.78±0.19)% vs. (0.77±0.18)%, t=0.091, P=0.928] between observation group and control group.
CONCLUSIONS: