Physiologic Hypoalbuminemia Is Well Tolerated by Severely Burned Children
| Autor: | Kathy Prelack, Robert L. Sheridan, John J. Cunningham |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Adult
Adolescent Globulin Burn Units Enteral administration Enteral Nutrition Albumins Humans Medicine Hypoalbuminemia Child Adverse effect Serum Albumin biology business.industry Albumin Infant medicine.disease Diarrhea El Niño Child Preschool Anesthesia biology.protein Serum Globulins medicine.symptom Burns business Feeding Intolerance |
| Zdroj: | The Journal of Trauma: Injury, Infection, and Critical Care. 43:448-452 |
| ISSN: | 1079-6061 |
| DOI: | 10.1097/00005373-199709000-00010 |
| Popis: | Background: Physiologic hypoalbuminemia, defined as a plasma albumin (pl-ALB) of 1.0 to 2.5 g/dL, is a component of the injury response. A consensus on the need for albumin supplementation in this setting is lacking. Methods: We examined 27 consecutive children (age, 7 ± 6 years) with >40% body surface burns (mean, 59 ± 18%) during their initial 4 weeks of care. Patients were managed with an albumin-supplementation protocol that tolerated profound physiologic hypoalbuminemia. Intravenous albumin was administered by infusion of 1 to 2 g/kg/d when pl-ALB fell below 1.0 g/dL, or below 1.5 g/dL in the presence of enteral feeding intolerance or pulmonary dysfunction. Supplementation was stopped when pl-ALB reached 2.0 g/dL. Results: Mean pl-ALB was 1.7 g/dL overall. Infusion for pl-ALB < 1.0 g/dL was needed for 70% (n = 19) of the patients. Profound physiologic hypoalbuminemia was constant, that is, mean weekly pl-ALB never exceed 2.5 g/dL in any patient. Mean plasma globulin rose during the 4 week period from 2.3 ± 0.1 at week 1 to 3.1 ± 0.1 at week 4. Diarrhea was negligible (19 of 756 patient days), nasogastric feedings were well tolerated, Pao 2 / Fio 2 ratios remained well above 150, wounds healed satisfactorily, and all children survived and have been discharged home. Conclusions: Profound physiologic hypoalbuminemia (pl-ALB of 1.0-2.5 g/dL) does not have adverse effects on pulmonary or gut function, wound healing, or outcome in severely burned children, perhaps because of a compensatory increase in acute-phase proteins reflected in plasma globulin. |
| Databáze: | OpenAIRE |
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