Albumin infusion for low serum albumin in preterm newborn infants

Jardine, Luke; Jenkins-Manning, S; Davies, Mark W

doi:10.1002/14651858.cd004208.pub2

Cited by 29 publications

(18 citation statements)

References 28 publications

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“…Our study used a homogeneous population of critically ill newborns, with comparable initial albumin levels, and no statistically significant difference regarding length of hospital stay and mortality between the groups. Prospective, randomized, controlled and double-blind studies did not find significant differences after albumin supplementation in the total length of hospital stay, in the necessity for mechanical ventilation, in the tolerance of enteral nutrition, morbidity, and in the reduction of mortality, despite a significant increase in serum albumin levels; 4,7,[29][30][31] these data are consistent with those obtained in the present study. In these studies and in the present study as well, there was an increase in serum albumin levels, but this increase did not reveal significant differences in relation to biochemical nutritional status (prealbumin and RBP levels) and did not show any differences as to the analyzed clinical parameters.…”

Section: Weight Outcomesupporting

confidence: 91%

Avaliação da suplementação de albumina humana exógena na nutrição parenteral total de recém-nascidos gravemente doentes

Porto¹,

Jorge²,

Assis³

2005

J. Pediatr. (Rio J.)

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Objective: In view of the controversies found in the literature, the present study was conducted to determine the effect of the use of exogenous human albumin on the nutritional status of newborn infants submitted to total parenteral nutrition.Methods: Thirty critically ill newborn infants weighing less than 2,500 g were divided into two groups: 15 infants receiving total parenteral nutrition without human albumin (C control group) and 15 with human albumin (group A). Total protein, albumin, prealbumin, and retinol-binding protein were determined at the beginning (3-4 days of postnatal age) and at the end of the study (10-11 days of postnatal age). On the seventh day of the study, nitrogen balance (retention) was measured. The following clinical parameters were evaluated: weight, age at the beginning of enteral nutrition, time to reach a full enteral volume, length of stay in the intensive care unit, total hospitalization time, and mortality. Results:The results showed a significant difference (p < 0.05) in serum albumin and total protein levels (p < 0.05) between groups at the end of the study. Median albumin levels were 2.95 g/dl in group C (2.71-3.16 g/dl), whereas group A showed median albumin levels of 4.10 g/dl, (3.76-4.66 g/dl). Total protein levels were 4.9 g/dl (4.4-5.2 g/dl) and 5.6 g/dl (5.5-6.3 g/dl), respectively, with no repercussions on any of the remaining parameters evaluated. Conclusions:On the basis of the results obtained in the present study, no benefits were derived from the use of human albumin in total parenteral nutrition in severely ill newborns; therefore its use cannot be recommended, unless the objective is exclusively to elevate albumin levels. J Pediatr (Rio J)

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Section: Weight Outcomesupporting

confidence: 91%

Avaliação da suplementação de albumina humana exógena na nutrição parenteral total de recém-nascidos gravemente doentes

Porto¹,

Jorge²,

Assis³

2005

J. Pediatr. (Rio J.)

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“…24,25 Whether albumin infusion would be beneficial in some circumstances in preterm babies is still controversial [25][26][27] and our findings further raise this issue.…”

Section: Discussionmentioning

confidence: 65%

Hypoproteinemia on the first day of life and adverse outcome in very preterm infants admitted to the neonatal intensive care unit

et al. 2011

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Objective: We aimed to investigate the relationship between day-1 hypoproteinemia and severe adverse outcome (SAO) in very preterm infants admitted to the neonatal intensive care unit (NICU).Study Design: Retrospective study of all patients born from 24 to 31 weeks gestation and cared for in our NICU over an 8-year period. Infants were excluded if the serum protein value on the first day of life was not available.Result: A total of 913 patients were included. In all, 14.6% presented with SAO (death or severe neurological injury on cranial ultrasound). Hypoproteinemia (total protein level <40 g l À1 ) on day 1 of life occurred in 19.5 % of all patients. The rate of SAO was 33.7% in patients with hypoproteinemia and 9.9% in those with normoproteinemia (P<0.0001). Logistic and multiple regression analysis confirmed that the association hypoproteinemia-SAO remained significant after adjustment for the other major predictors of outcome present at baseline (odds ratio 3.4; 95% confidence interval 2.1-5.4; P<0.0001).Conclusion: Hypoproteinemia was highly associated with SAO in this cohort of critically ill preterm infants. We are unable to explain the link between hypoproteinemia and adverse outcome in our population. This investigation serves as a hypothesis-generating report of a large preterm infants sample, and suggests the need to assess the predictive accuracy for adverse outcome of hypoproteinemia in future prospective studies.

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“…[8][9][10] In addition, there is a lack of evidence that albumin is associated with significant side effects such as infection. 11 The fact that some data in the literature have not shown increased mortality with albumin administration does not support its use, particularly in neonates with dehydration.…”

Section: Discussionmentioning

confidence: 99%

Albumin versus normal saline for dehydrated term infants with metabolic acidosis due to acute diarrhea

et al. 2009

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Objective: To compare the efficacy of albumin to normal saline (NS) for initial hydration therapy for dehydrated term infants with severe metabolic acidosis due to acute diarrhea.Study Design: We randomized 33 infants presenting with moderate-tosevere dehydration and metabolic acidosis (pH <7.25 or base excess (BE) <À15) into two groups, an albumin group (n ¼ 15) and a NS group (n ¼ 18). For initial hydration treatment, the albumin group received 5% albumin (10 ml kg À1 ), whereas the NS group received NS (10 ml kg À1 ).Result: After 3 h of treatment, both groups improved. However, the magnitude of improvement in the pH, BE and HCO 3 À levels were not different in comparisons between these two groups. In addition, there were no differences either in the body weight and weight gain 4 days after treatment or in the length of hospital stay. Conclusion:Albumin was not more effective than NS for initial hydration treatment of dehydrated term infants with metabolic acidosis due to acute diarrhea.

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Albumin infusion for low serum albumin in preterm newborn infants

Cited by 29 publications

References 28 publications

Avaliação da suplementação de albumina humana exógena na nutrição parenteral total de recém-nascidos gravemente doentes

Avaliação da suplementação de albumina humana exógena na nutrição parenteral total de recém-nascidos gravemente doentes

Hypoproteinemia on the first day of life and adverse outcome in very preterm infants admitted to the neonatal intensive care unit

Albumin versus normal saline for dehydrated term infants with metabolic acidosis due to acute diarrhea

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