Effect of Albumin Supplementation During Parenteral Nutrition on Hospital Morbidity

Albumin administration improves organ function in critically ill hypoalbuminemic patients: A prospective, randomized, controlled, pilot study*

“…Many studies have been conducted on the correction of hypoalbuminemia in various populations including newborns (17)(18)(19)(20), patients receiving total parenteral nutrition (21)(22)(23), and surgical patients (24,25). These small studies dealt with mortality as an end point and showed no benefit with albumin administration.…”

In My Opinion: Serum Albumin Should be Maintained During Neurocritical Care

“…Table 5 Albumin administration-non-neurological patients Meta-analysis of 79 randomized trials including 4755 patients with various conditions, no advantage in 25% of studies, but diverse endpoints showed advantage in others [32] 40 patients with acute lung injury demonstrated improved oxygenation, diuresis, and mean arterial blood pressure over a 3-day randomized prospective protocol of 25 g albumin plus furosemide each 8 h versus saline plus furosemide [33] Meta-analysis of 71 trials to evaluate morbidity among 3,782 acutely ill patients; albumin reduced complications (risk ratio 0.92) [34] 20 patients with acute lung injury in prospective comparison of saline versus albumin (each 8 h for 9 doses); better anti-oxidant capacity and lower protein oxidative damage [35] 100 medical/surgical ICU patients; randomized controlled trial of no albumin versus titrated albumin to maintain serum levels >3 g/dl; improved SOFA score with albumin in respiratory, cardiovascular, and neurological organ systems [36] 31 medical/surgical patients receiving TPN supplemented with albumin to a serum concentration >3 g/dl were compared against 30 patients receiving TPN alone. The treated groups had less pneumonia and septicemia but there was no difference in mortality between the two groups [37] Neurocrit Care (2011) 14:482-488 485…”

“…Investigations about maintaining serum albumin are limited, but are presented in Table 5 [32][33][34][35][36][37], for non-neurological patients, in Table 6 [38][39][40][41][42][43][44], for responses in animals after induced neurological injury, and in Table 7 [45][46][47][48][49], for humans following neurological catastrophes.…”

“…That possible quantitative effect is also suggested in the large meta-analysis by Vincent et al [54] wherein hypoalbuminemia above 3.0 g/dl was correlated with less morbidity. Brown et al [37] compared the patients in whom TPN was/was not supplemented with serum albumin to a serum concentration >3 g/dl and found the treated group had less pneumonia and sepsis, although mortality was the same. Similarly, Dubois et al [36] maintained serum albumin above 3 g/dl and found improved respiratory cardiovascular or neurological SOFA scores.…”

Intensivierte Insulintherapie bei Sepsis-Verbesserung der �berlebenschancen?

“…Konstitutive hepatische Proteine hingegen werden kaum noch synthetisiert und können sogar bis um zu 70% vermindert sein [12,13,14].Da die konstitutiven hepatischen Proteine wichtige physiologische Funktionen besitzen,wird ihre Abnahme als potentiell schädlich angesehen [4,13,14,19].Verschiedene Studien haben zusätzlich gezeigt, dass die Serum-Albumin-und Transferrinspiegel die Intensität des Traumas und Stresses widerspiegeln und als Marker für Morbidität und Mortalität herangezogen werden können [4]. Ziele der Akut-Phase-Reaktion sind die Wiederherstellung der Homöostase und die Regeneration.…”