The significance of hypoalbuminemia following injury and infection.

Serum albumin and absolute hepatic albumin synthetic rates were measured in ten seriously ill injured and septic patients using the (14C) carbonate technique. Although it is commonly believed that serum albumin levels (SAL) reflect hepatic function and visceral protein status in hospitalized patients, no relationship was found between these two measured parameters in this patient population. A depressed mean serum albumin level of 1.98 +/- 0.50 gm/dl (range: 1.25-2.69 gm/dl) was associated with a supranormal mean albumin synthetic rate of 215 +/- 121 mg/kg/day (range: 21-447 mg/kg/d). No significant mean SAL and albumin synthetic rate differences were noted between injured nonseptic and septic patient populations. Since albumin synthesis was elevated in most of these stressed patients these findings support the view that extravascular protein redistribution and/or increased peripheral catabolism are the major factors responsible for hypoalbuminemia in critically ill patients.