Albumin As a Nutrition
Albumin is used in a Nutritional Assessment as a rapid decrease in concentration is a sign of increasing inflammatory response. Rising albumin can be regarded as an improvement, which means that the patient is in an anabolic situation.
The albumin rises so only when the inflammatory response and reduces feeding made no impact.
Details
- Is a negative acute phase protein.
- If a reference value of 35 to 45 g / l.
- Responsible for 80% of the colloid osmotic pressure and comprises 50-60% of the total plasma protein.
- Is a transport protein for fatty acids, bilirubin and some hormones.
- Is synthesized in the liver, approximately 200 mg / kg / day, which is less than 5% of the total body stores. The synthesis capacity of the liver can increase 2-3 times. The body stock includes approximately 3.5-5.0 g / kg body weight and 35-40% of this is intravascular.
- Has a half life of 20 days.
- In an albumin of 34 g / l or less is an inflammatory response in the body (often with a rapid increase in CRP).
Research of Albumin
Almost 7 000 patients participated in the study, the risk of death for patients who received albumin was the same as that of patients who received saline (relative risk 0.99, confidence interval 95 % 0.91 to 1.09), which is answer questions about the safety of albumin raised in 1998. However, the study did not include severe burns, and exploratory analysis of the subgroup of trauma victims revealed that the mortality rate associated with the use of albumin was higher in patients who had a concomitant brain injury (relative risk 1.36, confidence interval 95% 0.99 to 1.86, p = 0.04). There was better survival in patients with sepsis who received albumin, but this observation was not significant statistically (relative risk 0.87, confidence interval 95% 0.74 to 1 , 02, p = 0.09), and its importance clinically is unclear. It should be noted that the study was not powered to show differences between subgroups and that such differences may be due to chance.
A new meta-analysis of various studies, including the SAFE study, conducted by the Cochrane Injuries Group3 and published October 18, 2004, the relative risk of death associated with the use of albumin in Hypovolemic patients would be 1, 01 (confidence interval 95% 0.92 to 1.10), so the use of albumin does not increase nor decrease mortality rate in these patients.
To determine whether the use of albumin has certain advantages or risks in certain subgroups of patients, we must conduct studies that focus specifically on this issue and have the necessary power.
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