Spontaneous bacterial peritonitis (SBP) is the most common infection in patients with end-stage liver disease (ESLD).
In critically ill patients, SBP can precipitate type 1 hepatorenal syndrome (HRS), which, if not treated, carries a mortality > 90%.
Infusion of albumin at 1.5 g/kg at the time of SBP diagnosis (and a second dose of 1 g/kg on day 3) has been shown to significantly decrease the incidence of type 1 HRS and decrease mortality.
In your next critically ill patient wth ESLD, strongly consider giving albumin at the time of SBP diagnosis.
References
Bernardi M, et al. Human albumin in the management of complications of liver cirrhosis. Crit Care 2012; 16:211.
