Correction of hypoalbuminemia after cardiac surgery in children: What level needs to be maintained?

Abstract

Research hypothesis. Maintenance of the target albumin level of less than 25 g/l in the postoperative period in children under 1 year of age does not affect the results of treatment.Materials and methods. A prospective randomized study included 70 patients after open cardiac surgery from January 2020 to June 2021. Two groups of 35 people were formed. Patients of the main group were transfused with albumin at its level below 25 g/l, the control group – less than 25 g/l. The median age at the time of surgery was 1.0 month in patients of both groups (p = 0.860), the median weight was 3.6 kg (3.0; 5.2) and 3.8 kg (3.1; 5.0) in patients of the main and control groups, respectively (p = 0.900).Results. At the preoperative stage, as well as in intraoperative parameters reflecting the complexity of the operation (Aristotle score, time of cardiopulmonary bypass and aortic clamping, delayed chest closure), the groups did not differ. On the 3rd and 4th days of the postoperative period, the level of albumin in patients of the main group was significantly lower (p = 0.027 and p = 0.034). Albumin transfusion in the ICU was more often performed in patients of the control group (p = 0.031). We did not find significant differences (time of inotropes use, artificial lung ventilation, stay in the intensive care unit, lethality).Conclusions. There were no significant differences in mortality between groups with different target levels of albumin. Also, no differences were found that could affect the outcome of the disease. Based on our study, it is impossible to draw conclusions about the course of the postoperative period in children with an albumin level of 25 g/l and below, since such an albumin level was not registered.