Hypoalbuminaemia in the perioperative period: Clinical significance and management options

Neel, Dustin; McClave, Stephen A.; Martindale, Robert G.

doi:10.1016/j.bpa.2011.07.006

Cited by 34 publications

(33 citation statements)

References 22 publications

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“…However, it should not be followed over time in hospitalized patients. Use of any marker (such as serum albumin, prealbumin, or transferrin) for nutrition status is controversial, since they represent “negative acute phase proteins” with levels altered by any stress, injury, infection, organ failure (liver and kidney), or acute phase response 14 . These markers that may have precipitated intervention may not change through the course of management 14 …”

Section: Preoperativementioning

confidence: 99%

“…Use of any marker (such as serum albumin, prealbumin, or transferrin) for nutrition status is controversial, since they represent “negative acute phase proteins” with levels altered by any stress, injury, infection, organ failure (liver and kidney), or acute phase response 14 . These markers that may have precipitated intervention may not change through the course of management 14 Provision of enteral nutrition (EN) when feasible is always the first choice for nutrition therapy for the elective surgery patient undergoing a major operative procedure.…”

Section: Preoperativementioning

confidence: 99%

“… Traditional markers of postoperative nutrition assessment such as serum albumin, prealbumin, and C‐reactive protein (CRP) reflect the metabolic response to surgery and not nutrition status 14 No physiologic principles support the use of a clear liquid diet as the first volitional intake.…”

Section: Postoperativementioning

confidence: 99%

See 2 more Smart Citations

Summary Points and Consensus Recommendations From the North American Surgical Nutrition Summit

McClave

Kozar²,

Martindale

et al. 2013

J Parenter Enteral Nutr

111

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Section: Preoperativementioning

confidence: 99%

Section: Preoperativementioning

confidence: 99%

See 1 more Smart Citation

Summary Points and Consensus Recommendations From the North American Surgical Nutrition Summit

McClave

Kozar²,

Martindale

et al. 2013

J Parenter Enteral Nutr

111

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“…Human serum albumin is a 66.5-kDa, negatively charged, and elliptically shaped protein that contributes up to 80% of the intravascular oncotic pressure [2].…”

Section: A-albuminmentioning

confidence: 99%

Statin Therapy

Koch¹

2012

CPD

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3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors are primarily used to treat dyslipidemia. Yet, these medications have a number of additional important pleiotropic properties that confer patient benefit in terms of reduced cardiovascular morbidity. Investigators have reported that statins may be underutilized in patients undergoing cardiac surgical procedures. Periprocedural benefits have been reported both in the short-term as well as with long - term post discharge follow-up period for both surgical and percutaneous coronary interventions. Mechanisms for statin's demonstrated benefit include improved endothelial function, antiinflammatory properties and stabilization of atherosclerotic plaque. While there are well-recognized side effects to statin therapy, its beneficial impact on patient cardiovascular outcomes is clear. Further research is necessary to determine specific patients who would best benefit from preoperative statin therapy, the dose and duration of therapy prior to surgical interventions and the influence of administration following surgery.

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“…Recent studies suggested that hypoalbuminaemia is able to increase the frequency of PUs in more than 70% of patients with a serum albumin level below 3·3 g/l A low serum albumin concentration correlates with increased length of stay in the ICU and with complication rates such as ventilatory dependency and development of new infections.…”

Section: Introductionmentioning

confidence: 99%

Albumin administration prevents the onset of pressure ulcers in intensive care unit patients

Serra

Grande

Buffone

et al. 2013

International Wound Journal

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Pressure ulcers (PUs) are a common problem in critically ill patients admitted to the intensive care units (ICUs) and they account for more than 70% of patients with low serum albumin at admission. The aim of this study was to test the efficacy of intravenous administration of albumin in patients with low serum albumin < 3·3 g/dl. In a 1-year period, a total of 73 patients were admitted to the ICU (males 45, 61·64% and females 28, 38·36%); of these, 21 patients were admitted with hypoalbuminaemia (serum albumin < 3·3 g/dl) and randomised into two groups: 11 patients were treated with 25 g intravenous albumin for the first 3 days within the first week of ICU stay (group A) and 10 patients did not receive albumin (group B). Three patients (27·27%) showed the onset of PUs in group A, whereas seven patients (70%) showed the onset of PUs within the first 7 days of stay in group B. Moreover, ulcers of group B were more severe than those of group A. This study shows that intravenous administration of albumin reduces the onset of PUs in patients admitted to the ICU and in some cases it also reduces the risk of progression to advanced stages of PUs.

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Hypoalbuminaemia in the perioperative period: Clinical significance and management options

Cited by 34 publications

References 22 publications

Summary Points and Consensus Recommendations From the North American Surgical Nutrition Summit

Summary Points and Consensus Recommendations From the North American Surgical Nutrition Summit

Statin Therapy

Albumin administration prevents the onset of pressure ulcers in intensive care unit patients

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