Effect of hypoalbuminemia and parenteral nutrition on free water excretion and electrolyte-free water resorption

Wojtysiak, Stacey L.; Brown, Rex O.; Roberson, Donald N.; Powers, Douglas A.; Kudsk, Kenneth A.

doi:10.1097/00003246-199202000-00005

“…Thus, differences in weight gain might be partly explained by positive effects of a higher serum albumin level and of higher oncotic pressure, with improved tolerance of the diet by newborns. 27 Similarly, studies conducted with adult patients also revealed a positive correlation between serum albumin levels and better tolerance of enteral nutrition, 28 which could not be statistically confirmed in the present study. In newborns, the use of albumin in TPN also had some influence on the implementation of enteral nutrition and showed that the treated group regained birthweight more quickly.…”

Section: Weight Outcomecontrasting

confidence: 86%

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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“…Assim, diferenças no ganho de peso poderiam ser explicadas, em parte, pelos efeitos positivos de um nível sérico mais alto de albumina e de pressão oncótica, com melhora na tolerância à dieta pelos RN 27 . De modo similar, estudos em pacientes adultos também encontraram correlação positiva entre níveis séricos de albumina e melhor tolerância à alimentação enteral 28 , o que não pôde ser comprovado estatisticamente no presente estudo. Em RN, a utilização de albumina na NPT também mostrou repercussão sobre o início da alimentação enteral, com recuperação mais rápida do peso de nascimento no grupo tratado 3 .…”

Section: Variáveisunclassified

Exogenous human albumin supplementation in total parenteral nutrition of critically ill newborns

Porto¹,

Jorge²,

Assis³

2005

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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). 2005;81(1):41-6: Albumin, parenteral nutrition, newborn. ResumoObjetivo: Diante das controvérsias encontradas na literatura, procurou-se verificar a influência do uso de albumina humana exógena sobre o estado nutricional e a evolução de parâmetros clínicos de recém-nascidos em nutrição parenteral total.Métodos: Estudo caso-controle incluindo 30 recém-nascidos gravemente doentes com peso inferior a 2.500 g, divididos em dois grupos: 15 recém-nascidos recebendo nutrição parenteral total sem albumina (grupo controle C) e 15 com albumina humana (grupo A). Foram realizadas dosagens de proteínas totais, albumina, pré-albumina e proteína ligadora do retinol no início (3-4 dias) e no fim do estudo (10-11 dias de idade pós-natal). No sétimo dia de estudo, foi realizado balanço da retenção de nitrogênio. Foram avaliados os seguintes parâmetros clínicos: peso, idade de início da alimentação enteral, tempo para atingir volume enteral pleno, tempo de permanência na unidade de terapia intensiva, tempo total de internação e mortalidade.Resultados: Houve diferença significativa (p < 0,05) nos níveis séricos de albumina e das proteínas totais entre os grupos ao final do estudo. Para os níveis de albumina, o grupo C obteve mediana de 2,95 g/dl (2,71-3,16 g/dl), e o grupo A, mediana de 4,10 g/dl (3,76-4,66 g/dl). Para os níveis de prot...

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“…Some studies showed a benefit of this practice, but others did not. 21,[30][31][32][33] It is obvius that serum albumin levels were elevated in all of these studies.…”

Section: Discussionmentioning

confidence: 87%

Albumin Infusion is not Beneficial in Hypoalbuminemic End-Stage Cancer Patients: A Matched-Pair Analysis

Büyükçelik¹

2012

UHOD

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In this retrospective study, it was aimed whether albumin infusion is benefical or not in terminally ill hospitalized hypoalbuminemic cancer patients. Between March 2000 and 31 March 2003, the medical records of 27 terminally ill hypoalbuminemic cancer patients who had albumin infusion(Albumin receiving group-ARG), were retrospectively analysed. This grup was matched (1:1) with 27 terminally ill cancer patients who had no albumin infusion (Albumin not receiving group-ANRG), according to age, sex, ECOG PS, diagnosis and the number of metastatic sites. ARG was compared with ANRG, in regard to the changes of pulse rate, blood pressure, in the levels of serum BUN, creatinin, sodium, total protein, and albumin before albumin infusion and 48 hours after albumin infusion, and documented and/or clinical infections after albumin infusion, hospitalization duration, the rate of exitus in hospital and overall survival. There was no difference in patient characteristics between two groups. Likewise, the groups were not different from each other in terms of the changes of puls rate, blood pressure, in the levels of serum BUN, creatinin, sodium, and documented and/or clinical infections after albumin infusion (p> 0.05). There was a significant increase in the levels of serum total protein and albumin in ARG (p< 0.05). The rate of exitus in hospital is not different between two groups. The median duration of hospitalization was longer in ANRG (p= 0.022). The overall survival was significantly better in ANRG (p= 0.018). Albumin infusion is not benefical in terminally ill hypoalbuminemic cancer patients. Furthermore, it was found that the survival was significantly worse in patients receiving albumin.

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Effect of hypoalbuminemia and parenteral nutrition on free water excretion and electrolyte-free water resorption

Cited by 50 publications

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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

Exogenous human albumin supplementation in total parenteral nutrition of critically ill newborns

Albumin Infusion is not Beneficial in Hypoalbuminemic End-Stage Cancer Patients: A Matched-Pair Analysis

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