Document Detail


Serum albumin and colloid osmotic pressure in survivors and nonsurvivors of prolonged critical illness.
MedLine Citation:
PMID:  9797519     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We retrospectively compared the changes in serum albumin concentration and colloid osmotic pressure between survivors and nonsurvivors of prolonged (> or = 7 days) critical illness over a 2-year period from 1 July 1995. All patients had serum albumin measured daily, and colloid osmotic pressure measured 5 days a week, throughout their ICU admission. They received crystalloid and colloid infusions as well as parenteral or enteral feeding. Infusions of albumin were not used to treat hypoalbuminaemia. One hundred and forty-five patients were included, 66 nonsurvivors and 79 survivors. Nonsurvivors were significantly older than survivors [mean (95% CI): 58 (3.8) and 49 (4.1) years, respectively] and had a greater risk of death [mean (95% CI): 0.44 (0.06) and 0.28 (0.05); p < 0.05]. There was no significant difference in gender, APACHE II score [mean (95% CI): 22 (2.7) (nonsurvivors); 18 (2.3) (survivors)] or length of stay [median (interquartile range): 14 (9-27) days (nonsurvivors); 15 (9-26) days (survivors)]. There was no difference between the two groups in the absolute minimum serum albumin concentrations reached, the time to reach that minimum or the minimum in the first 7 days. However, nonsurvivors had a significantly lower mean serum albumin concentration: [mean (95% CI): 15.7 (5.1) g.l-1 compared with 18.3 (4.6) g.l-1 in survivors; p < 0.05]. They also had a lower recovery mean (the weighted mean after the minimum value): [mean (95% CI): 13.3 (5.1) g.l-1 (nonsurvivors) and 18.6 (5.3) g.l-1 (survivors); p < 0.01]. Analysis of colloid osmotic pressure results showed no difference between the groups in mean, minimum or recovery mean. Regression analysis of mean colloid osmotic pressure and albumin revealed that albumin only contributed 17% of the colloid osmotic pressure in these patients. The similar decrease in albumin in nonsurvivors and survivors may reflect the acute inflammatory response and/or haemodilution. However, survivors showed an ability to increase serum albumin concentrations, possibly owing to resumption of synthesis. The colloid osmotic pressure varied little between or within either group of patients, possibly because of the use of artificial colloids. There was no relationship between death and colloid osmotic pressure.
Authors:
M C Blunt; J P Nicholson; G R Park
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anaesthesia     Volume:  53     ISSN:  0003-2409     ISO Abbreviation:  Anaesthesia     Publication Date:  1998 Aug 
Date Detail:
Created Date:  1998-11-04     Completed Date:  1998-11-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  755-61     Citation Subset:  AIM; IM    
Affiliation:
John Farman ICU, Addenbrooke's Hospital, Cambridge, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Biological Markers / blood
Colloids
Critical Illness / therapy*
Female
Follow-Up Studies
Humans
Intensive Care
Male
Middle Aged
Osmotic Pressure
Prognosis
Retrospective Studies
Risk Factors
Serum Albumin / metabolism*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Colloids; 0/Serum Albumin

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