Response to: A randomized-controlled trial comparing 20% albumin to plasmalyte in patients with cirrhosis and sepsis-induced hypotension [ALPS trial]

Sergio Maimone; Vincenzo Francesco Tripodi; Anna Teresa Mazzeo

doi:10.1016/j.jhep.2022.07.001

Letter to the Editor| Volume 77, ISSUE 6, P1731-1732, December 2022

Response to: A randomized-controlled trial comparing 20% albumin to plasmalyte in patients with cirrhosis and sepsis-induced hypotension [ALPS trial]

Sergio Maimone
Sergio Maimone
Correspondence
Corresponding author. Address: Division of Medicine and Hepatology, University Hospital of Messina, Messina, Italy.
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Affiliations
Division of Medicine and Hepatology, University Hospital of Messina, Messina, Italy
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Vincenzo Francesco Tripodi
Vincenzo Francesco Tripodi
Affiliations
Surgery Department, Anesthesia and Intensive Care, University Hospital of Messina, Messina, Italy
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Anna Teresa Mazzeo
Anna Teresa Mazzeo
Affiliations
Human Pathology Department, Anesthesia and Intensive Care, University Hospital of Messina, Messina, Italy
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Published:July 07, 2022DOI:https://doi.org/10.1016/j.jhep.2022.07.001

Sepsis and septic shock in patients with cirrhosis is a leading cause of acute decompensation or acute-on-chronic liver failure and is associated with poor prognosis and increased mortality.

^[1]

Evans L.
Rhodes A.
Alhazzani W.
Antonelli M.
Coopersmith C.M.
French C.
et al.

Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021.

^,

^[2]

Wong F.
Piano S.
Singh V.
Bartoletti M.
Maiwall R.
Alessandria C.
et al.

International Club of Ascites Global Study Group
Clinical features and evolution of bacterial infection-related acute-on-chronic liver failure.

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A randomized-controlled trial comparing 20% albumin to plasmalyte in patients with cirrhosis and sepsis-induced hypotension [ALPS trial]
Journal of HepatologyVol. 77Issue 3
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  The choice of resuscitation fluid in patients with cirrhosis and sepsis-induced hypotension is unclear. 5% albumin was superior to normal saline in the FRISC study. We compared the efficacy and safety of 20% albumin, which has greater oncotic properties, to plasmalyte in reversing sepsis-induced hypotension.
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Reply to: “Response to: A randomized-controlled trial comparing 20% albumin to plasmalyte in patients with cirrhosis and sepsis-induced hypotension [ALPS trial]”
Journal of HepatologyVol. 77Issue 6
- Preview
  We want to thank Maimone et al. for taking keen interest in our recently published ALPS trial, comparing 20% albumin to plasmalyte for fluid resuscitation in sepsis-induced hypotension in critically ill patients.¹ We agree with their suggestions on using point-of-care ultrasound to assess volume status for guiding fluid management in patients admitted to the intensive care unit. Accurate assessment of the fluid status is the key in managing patients with complex hemodynamic alterations associated with organ dysfunction.
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Published online: July 07, 2022

Accepted: July 1, 2022

Received: June 9, 2022

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DOI: https://doi.org/10.1016/j.jhep.2022.07.001

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Response to: A randomized-controlled trial comparing 20% albumin to plasmalyte in patients with cirrhosis and sepsis-induced hypotension [ALPS trial]

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