2016, Number 2
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Rev Acta Médica 2016; 17 (2)
Use of albumin in the critical care setting
León PDO
Language: Spanish
References: 27
Page:
PDF size: 87.68 Kb.
ABSTRACT
Albumin is the main determinant of oncotic pressure and the body´s most abundant
plasma protein. The conditions regulating the rate of albumin synthesis are basically:
oncotic pressure, nutritional status and hormones. Hypoalbuminemia is associated with
poor clinical outcomes, mainly in critically ill patients, so exogenous administration is
an attractive and widely used therapeutic strategy, although this entails risk of
complication and even death. In the context of the critical patient, albumin has been
used with treatment functions, nutritional status assessment and as a predictor of
mortality or complications. Despite the existing literature, no agreement has been
reached on the indications for the use of albumin, since in the different clinical contexts
(resuscitation, sepsis, postoperative, burned, nephrotic syndrome, adult respiratory
distress syndrome), there are no significant advantages in terms of morbidity and
mortality when comparing its use with that of crystalloids or other synthetic colloids,
not to mention also the economic cost of its use.
REFERENCES
Sabesin SM. Metabolismo hepático. In: Teixidor DJR, editor. Medicina Interna. La Habana: Edición Revolucionaria; 1987. p. 22-8.
Pacheco S, Guevara R, Céspedes P, Darras E, Mallea Yáñez L. Albúmina en el paciente crítico: ¿Mito o realidad terapéutica? Rev Chil Pediatr. 2007;78(4):403-13.
Cabral VL, de Carballo L, Misz ST. Importance of serum albumin in nutritional assessment and inflammatory activity in patients with Crohns disease. J Hum Nutr Diet. 2002; 15(3):189-92.
Marino P. Reposición con coloides y cristaloides. In: Lippincot, William & Wilkins, editor. El libro de la UCI. 3ra. ed. 2010. p. 221-41.
Jones AE, Kline JA. Shock. In: Marx JA, editor. Rose´n Emergency Medicine Concepts and Clinical Practice. 8va. ed. 2014. p. 67-74.
Falcão H, Japiassú, AM. Uso de albumina humana em pacientes graves: controvérsias e recomendações. Rev bras ter intensiva. 2011;23(1):87-95.
The SAFE Study investigators. Saline or Albumin for Fluid Resuscitation in Patients with Traumatic Brain Injury. N Engl J Med. 2007;357:874-84.
Alderson P, Bunn F, Lefebvre C, Li WP, Li L, Roberts I, et al. Albumin Reviewers. Human albumin solution for resuscitation and volume expansion in critically ill patients. Cochrane Database Syst Rev. 2004;4.
Schortgen FGE, Deye N, Brochard L. The risk associated with hyperoncotic colloids in patients with shock. Intensive Care Med. 2008. [H1]
Guacira M, Rozenfeld S, Martins M. Uso de albumina humana nos hospitais da Região Metropolitana do Estado do Rio de Janeiro, Brasil. Cad Saude Publica. 2010;26(5):981-90.
Vincent JL, Sakr Y, Reinhart K, Sprung CL, Gerlach H, Ranieri MV. Is albumin administration in the acutely ill associated with increased mortality? Results of the SOAP study. Critical Care. 2005;9:R745-54.
Jacob M, Chappell D, Conzen P, Wilkes MM, Becker BF, Rehn M. Small-volume resuscitation with hyperoncotic albumin: a systematic review of randomized clinical trials. Critical Care. 2008;12:R34.
Honore P, Joannes-Boyau O, Boer W. Hyperoncotic colloids in shock and risk of renal injury: enough evidence for a banning order? Intensive Care Med. 2008 Dec;34(12):2127-9.
Brugler L, Stankovic A, Bernstein L, Scott F, O'Sullivan-Maillet J. The role of visceral proteins in protein calorie malnutrition. Clin Chem Lab Med. 2002;40:1360-9.
Cabral VL, De Carballo L, Misz Pectin ST. Importance of serum albumin values in nutritional assessment and inflammatory activity in patient with Crohn's disease. J Hum Nutr Diet. 2002;15(3):189-92.
Montejo González JC, Culebras Fernández JM, García de Lorenzo A. Recomendaciones para la valoración nutricional del paciente crítico. Rev Méd Chile. 2006;134(8):1049-56.
León Pérez D, Molina Ricardo Y. Evaluación del estado nutricional. In: Silvariño NC, editor. Medicina Intensiva. Nutrición del paciente crítico. La Habana: 2014. p. 17-22.
Hernández Pedroso W, Rittoles Navarro A, Joanes Fiol J, García Hernández R. Estado nutricional en el paciente quirúrgico grave. Rev Cubana Med Milit. 2005;34(2):241-5.
Socarrás Suárez MM. Algunas causas que llevan a la desnutrición en los pacientes hospitalizados. Rev Cubana Med. 2004;43(2):15-21.
Kuzuya M, Izawa S, Enoki H, Okada K, Iguchi A. Is serum albumin a good marker for malnutrition in the physically impaired elderly? Clinical Nutrition. 2007;26:84-90.
Medina H, Ramos A, Torres G, Tapia H. Factores asociados a mortalidad en cirugía mayor: análisis retrospectivo en un centro de referencia. Rev Invest Clin. 2006;58(1):9-14.
Ramos Martínez A, Asensio Vegas A, Núñez Palomo S, Millán Santos I. Prevalencia y factores asociados a malnutrición en ancianos hospitalizados. An Med Interna. 2004;21:263-8.
Pedersen T, Möller A, Goztsche P. Human albumin in critically patients. Crit Care Med. 2005;33:1183-4.
Porto BS, Jorge SM, de Assis MG. Exogenous human albumin supplementation in total parenteral nutrition of critically ill newborns. J Pediatr (Rio J). 2005;81(1):41-6.
Vincent J, Navickis R, Wilkes M. Morbidity in hospitalized patients receiving human albumin: A metaanalysis of randomized, controlled trials. Crit Care Med. 2004;32:2029-38.
Gómez Ramos MJ, González Valverde FM, Sánchez Álvarez C. Estudio del estado nutricional en la población anciana hospitalizada. Nutr Hosp. 2005;20(4):1-11.
Vincent J, Dubois M, Navickis R. Hipoalbuminemia in acute illness: Is there a rationale for intervention? Ann Surg. 2003;237:319-34.