Literature DB >> 1737453

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

S L Wojtysiak1, R O Brown, D Roberson, D A Powers, K A Kudsk.   

Abstract

OBJECTIVE: To measure the effect of human albumin supplementation during parenteral nutrition on serum albumin concentrations, colloid oncotic pressure, free water clearance, electrolyte-free water resorption, and sodium excretion.
DESIGN: Prospective, randomized, controlled trial.
SETTING: Tertiary care center. PATIENTS: Thirty adult, hypoalbuminemic patients who required parenteral nutrition.
INTERVENTIONS: Parenteral nutrition (control) or parenteral nutrition plus human albumin 25 g/L as a continuous infusion (treatment) for a 5-day study period. MEASUREMENTS: On days 1 and 5, serum albumin concentration, colloid oncotic pressure, free water clearance, electrolyte-free water resorption, and sodium excretion were measured.
RESULTS: Serum albumin concentrations increased significantly from day 1 to day 5 in both groups (control: 2.0 +/- 0.1 [mean +/- SEM] vs. 2.3 +/- 0.1 g/dL [20 +/- 1 vs. 23 +/- 1 g/L], p = .02; treatment: 2.2 +/- 0.1 vs. 3.5 +/- 0.2 g/dL [22 +/- 1 vs. 35 +/- 2 g/L], p = .0001). Day 5 serum albumin concentrations were significantly higher in the treatment group compared with control (p = .0001). Colloid oncotic pressure increased significantly from day 1 to day 5 in the treatment group (17.8 +/- 0.8 vs. 25.1 +/- 1.0 mm Hg, p = .0001), and was significantly higher than control at day 5 (p = .0001). No significant differences were found for free water clearance, electrolyte-free water resorption, or sodium excretion within or between groups.
CONCLUSIONS: In hypoalbuminemic patients, human albumin supplementation during parenteral nutrition results in significant increases in serum albumin concentrations and colloid oncotic pressure, but has no apparent effect on free water clearance, electrolyte-free water resorption, or sodium excretion.

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Year:  1992        PMID: 1737453     DOI: 10.1097/00003246-199202000-00005

Source DB:  PubMed          Journal:  Crit Care Med        ISSN: 0090-3493            Impact factor:   7.598


  7 in total

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2.  'What's the serum albumin?'.

Authors:  N Williams; A D Scott
Journal:  Ann R Coll Surg Engl       Date:  1998-03       Impact factor: 1.891

3.  Hypoalbuminemia in acute illness: is there a rationale for intervention? A meta-analysis of cohort studies and controlled trials.

Authors:  Jean-Louis Vincent; Marc-Jacques Dubois; Roberta J Navickis; Mahlon M Wilkes
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4.  Albumin bolus administration versus continuous infusion in critically ill hypoalbuminemic pediatric patients.

Authors:  A Greissman; P Silver; L Nimkoff; M Sagy
Journal:  Intensive Care Med       Date:  1996-05       Impact factor: 17.440

5.  Human albumin administration in critically ill patients: systematic review of randomised controlled trials.

Authors: 
Journal:  BMJ       Date:  1998-07-25

Review 6.  The appropriate role of colloids in managing fluid imbalance: a critical review of recent meta-analytic findings.

Authors:  A R Webb
Journal:  Crit Care       Date:  2000-10-13       Impact factor: 9.097

Review 7.  Randomised trials of human albumin for adults with sepsis: systematic review and meta-analysis with trial sequential analysis of all-cause mortality.

Authors:  Amit Patel; Michael A Laffan; Umeer Waheed; Stephen J Brett
Journal:  BMJ       Date:  2014-07-22
  7 in total

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