Furosemide and Albumin for Diuresis of Edema (FADE): A parallel-group, blinded, pilot randomized controlled trial

Simon J.W. Oczkowski, Lisa Klotz, Ian Mazzetti, Fayez Alshamsi, Mei Lin Chen, Gary Foster, Maureen O. Meade, Cindy Hamielec

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Purpose: To assess the feasibility of a trial evaluating whether hyperoncotic albumin, in addition to diuretics, improves diuresis and facilitates liberation from mechanical ventilation in critically ill adults. Materials and methods: We randomized 46 hemodynamically stable patients with hypoalbuminemia, prescribed diuretics by treating clinicians, to receive 100 mL of 25% albumin or 0.9% saline placebo BID, for three days, in blinded fashion. We chose five feasibility measurements: enrolment of 50% of eligible patients, at least one patient/week; administration of study treatment within 2 h of diuretics in 85% of patients; completion of study regimen in 80% of patients; and avoidance of open label albumin in 85% of patients. Clinical outcomes included fluid balance, ventilator-free days, and mortality. Results: We randomized 85% of eligible patients. Eighty-four percent received study treatment within 2 h of diuretics, 69% received all doses of study treatment. Study treatment was held in the albumin and placebo groups because of no further need for diuresis (4 vs. 1), hypotension (2 v. 4), and albumin > 35 (1 v. 0). Twenty percent of patients received open-label albumin. Clinical outcomes were similar between groups. Conclusions: The current study design did not demonstrate feasibility, but can inform the design of a definitive trial.

Original languageEnglish
Pages (from-to)462-467
Number of pages6
JournalJournal of Critical Care
Volume48
DOIs
Publication statusPublished - Dec 2018

Keywords

  • Albumin
  • Diuretics
  • Edema
  • Fluid overload

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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