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Microalbuminuria does not reflect increased systemic capillary permeability in septic shock
Zsolt Molnár1, Tamás Szakmány, Péter Heigl
1Department of Anaesthesiology and Intensive Care, University of Pécs, Pécs, Hungary. z_molnar@hotmail.com
Intensive Care Medicine
|February 1, 2003
Summary
In septic shock patients, elevated extravascular lung water did not correlate with microalbuminuria. Routine microalbuminuria testing is not recommended for assessing endothelial permeability in critically ill patients.
Area of Science:
- Critical Care Medicine
- Pulmonology
- Nephrology
Background:
- Septic shock frequently leads to severe respiratory failure requiring mechanical ventilation.
- Assessing endothelial permeability is crucial in managing critically ill patients.
- Extravascular lung water (EVLW) is an indicator of pulmonary edema.
Purpose of the Study:
- To investigate the correlation between microalbuminuria and extravascular lung water (EVLW) in patients with septic shock.
- To determine if microalbuminuria can serve as a marker for endothelial permeability in this population.
Main Methods:
- Prospective, observational study involving 25 septic shock patients requiring mechanical ventilation.
- Hemodynamic parameters and EVLW measured via single arterial thermodilution.
- Urinary microalbumin to creatinine ratio (M:Cr), PaO(2)/FIO(2), serum C-reactive protein (CRP), and procalcitonin (PCT) were assessed.
Main Results:
- Patients exhibited significantly elevated EVLW.
- Microalbuminuria remained within normal ranges throughout the study.
- No significant correlation was found between M:Cr and EVLW or PaO(2)/FIO(2).
- Serum PCT and CRP levels were significantly elevated.
Conclusions:
- Elevated EVLW in septic shock patients was not associated with abnormal microalbuminuria.
- Microalbuminuria does not appear to be a reliable indicator of endothelial permeability in this context.
- Routine measurement of microalbuminuria is not recommended for assessing endothelial permeability in critically ill patients.