Skip to main content

Volume 15 Supplement 3

Sepsis 2011

Use of plasma protein fraction in patients with septic shock admitted to the ICU

Introduction

Certain colloids like albumin and plasma protein fraction (PPF) have been derived from human plasma and they are used as plasma expanders to treat patients with shock. PPF, which more closely resembles plasma in its constituents, contains albumin plus α and β globulins. We conducted this study to assess the effect of PPF on need for vasopressors, organ support and ICU mortality in patients with septic shock.

Methods

A retrospective study was conducted and data were collected from the records of patients admitted to a 16-bed neuro and medical ICU over a 1.5-year period. All adult patients admitted with septic shock and requiring vasopressor support (for more than 6 hours) in spite of aggressive fluid resuscitation were enrolled. Patients who were transferred from some other ICU or ward and those who developed shock during their ICU course were excluded from the analysis. Patients were divided into two groups: patients in whom PPF was used along with resuscitative fluids comprised the study group, whereas others formed the control group. Patients in these groups were compared according to need for organ support, ICU mortality and time taken to stop vasopressor agents. PPF (Plasmanate®) was administered in a protocolized way at the dosage of 10 to 20 ml/hour for the first 48 hours. Development of any complication like allergy or hypotension associated with PPF was also noted.

Results

There was no significant difference in the baseline characteristics of patients in both groups in terms of age (P = 0.154), sex (P = 0.479), severity of illness (APACHE II score, P = 0.356), and presence of organ failure (SOFA score, P = 0.105). Among the outcome parameters there was no significant difference in terms of need for renal support (P = 0.814), mechanical ventilation (P = 0.776), ICU stay (P = 0.122), hospital stay (P = 0.054) and ICU mortality (P = 0.091). However, there was a significant difference in time taken to stop the vasopressors (P = 0.030) (Table 1). There were no incidences of any complications or side effects in any group.

Table 1 Comparison between patient characteristics and ICU course among patients in control and PPF groups

Conclusion

PPF may be used safely and effectively for initial resuscitation of patients with septic shock requiring vasopressor support. It may lead to early termination of vasopressor support; however, it did not translate to lesser need for organ support or reduced ICU mortality in our patient cohort. To demonstrate such benefits, larger multicenter trials are warranted.

Author information

Affiliations

Authors

Corresponding author

Correspondence to D Juneja.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Juneja, D., Singh, O., Nasa, P. et al. Use of plasma protein fraction in patients with septic shock admitted to the ICU. Crit Care 15, P13 (2011). https://doi.org/10.1186/cc10382

Download citation

Keywords

  • Mechanical Ventilation
  • Septic Shock
  • Organ Support
  • Fluid Resuscitation
  • Plasmanate