Surgical-trauma patients with open abdomen administered with intravenous crystalloid appear to have the shortest time to abdomen closure relative to those who received bolus or continuous albumin, a recent study has shown.
Eighty-four adults with open abdomen participated in this retrospective cohort study from 2012 through 2018. The authors stratified participants by intravenous fluid administration into continuous albumin infusion, intermittent bolus albumin, or crystalloid. Each cohort consisted of 28 patients.
Median time to abdomen closure was the primary endpoint. Secondary endpoints were length of stay (LOS), haemodynamic parameters, and mortality. Cox proportional hazards regression was used to estimate time to final abdomen.
In Cox regression analysis, the median time to abdomen closure was found to be significantly shorter with crystalloids (44.2 hours) than with bolus albumin (79.0 hours; p=0.002) and continuous albumin (63.6 hours; p=0.001).
Additionally, the incidence of hospital death was highest in the bolus albumin cohort (continuous albumin vs bolus albumin vs crystalloid: 21.4 precent vs 50.0 percent vs 25.0 percent; p=0.044). Other secondary outcomes did not differ significantly between groups.
“Further evaluation of continuous albumin infusion in patients with open abdomen is needed,” the authors said.
Open abdomen is an intentional lack of fascial closure following abdominal cavity opening. This procedure is used for different indications among patients with surgical trauma, according to the authors.