T L Hwang1, M C Lue, Y J Nee, Y Y Jan, M F Chen. 1. Nutritional Support Service, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan, Republic of China.
Abstract
OBJECTIVES: Critically ill patients usually have hypoalbuminemia. The incidence of diarrhea in patients with hypoalbuminemia receiving enteral nutrition was studied. METHODS: One hundred and ninety-eight patients with serum albumin level below 3 g/dl in the Burn Unit and Nutritional Support Service were retrospectively studied. Diarrhea was defined as liquid or loose stool at least three times a day with a daily volume of more than 300 g for at least 2 days. Most patients in the Burn Unit had acute or subacute onset of hypoalbuminemia, and most patients who were referred to the Nutritional Support Service had a chronic onset of hypoalbuminemia. The patients whose diarrhea were due to formula-related factors, administration techniques, or concomitant drug therapy were excluded. RESULTS: The results showed that 27% of the patients with albumin levels less than 2 g/dl had diarrhea, but only 10.5% of patients with albumin levels higher than 2 g/dl had diarrhea; the difference was significant. Diarrhea occurred in 35.1% of the patients with chronic development of hypoalbuminemia, but only 9.9% of the patients with rapid development of hypoalbuminemia had diarrhea; that difference also was significant. CONCLUSIONS: We concluded that the hypoalbuminemia-related diarrhea during tube feeding was significantly higher in patients with albumin levels less than 2 g/dl, and the patients with hypoalbuminemia due to chronic malnutrition had a significantly higher incidence of diarrhea than those with acute malnutrition, such as burned patients.
OBJECTIVES:Critically illpatients usually have hypoalbuminemia. The incidence of diarrhea in patients with hypoalbuminemia receiving enteral nutrition was studied. METHODS: One hundred and ninety-eight patients with serum albumin level below 3 g/dl in the Burn Unit and Nutritional Support Service were retrospectively studied. Diarrhea was defined as liquid or loose stool at least three times a day with a daily volume of more than 300 g for at least 2 days. Most patients in the Burn Unit had acute or subacute onset of hypoalbuminemia, and most patients who were referred to the Nutritional Support Service had a chronic onset of hypoalbuminemia. The patients whose diarrhea were due to formula-related factors, administration techniques, or concomitant drug therapy were excluded. RESULTS: The results showed that 27% of the patients with albumin levels less than 2 g/dl had diarrhea, but only 10.5% of patients with albumin levels higher than 2 g/dl had diarrhea; the difference was significant. Diarrhea occurred in 35.1% of the patients with chronic development of hypoalbuminemia, but only 9.9% of the patients with rapid development of hypoalbuminemia had diarrhea; that difference also was significant. CONCLUSIONS: We concluded that the hypoalbuminemia-related diarrhea during tube feeding was significantly higher in patients with albumin levels less than 2 g/dl, and the patients with hypoalbuminemia due to chronic malnutrition had a significantly higher incidence of diarrhea than those with acute malnutrition, such as burned patients.
Authors: Yves M Borbély; Alice Osterwalder; Dino Kröll; Philipp C Nett; Roman A Inglin Journal: World J Gastroenterol Date: 2017-07-14 Impact factor: 5.742