Abstract
Albumin has been the focus of literally thousands of articles since its first use in the clinical setting during World War II. Despite being at the centre of several clinical controversies, many questions still remain regarding the use and abuse of albumin. The major physiologic functions include maintaining colloid osmotic pressure, binding and transport of metabolically active molecules, serving as an antioxidant, use as a surrogate marker of nutritional status and predictor of outcome in elective surgical populations, having an anti-thrombotic influence on platelets, aiding in acid-base balance and having a protective influence on capillary membrane integrity. Albumin will continue to be widely used in clinical medicine despite many of the drawbacks. It now appears the benefits in the use of albumin in most cases outweigh the risks. The clinical implications of hypoalbuminaemia as an indicator of surgical or intensive care unit (ICU) outcome or nutritional status is clearly disease- and organ specific. The use of albumin as a volume expander appears to have limited, if any, benefit over crystalloid. The "secondary" benefits of albumin in specific surgical and intensive-care conditions, such as sepsis and organ dysfunction, are numerous and are well supported in the current literature.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 395-400 |
| Number of pages | 6 |
| Journal | Best Practice and Research: Clinical Anaesthesiology |
| Volume | 25 |
| Issue number | 3 |
| DOIs | |
| State | Published - Sep 2011 |
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Keywords
- albumin
- antioxidant
- capillary integrity
- colloid osmotic pressure
- hypoalbuminemia
- surrogate nutrition indicator
- volume expansion
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
Cite this
Hypoalbuminaemia in the perioperative period : Clinical significance and management options. / Neel, Dustin R.; McClave, Stephen; Martindale, Robert.
In: Best Practice and Research: Clinical Anaesthesiology, Vol. 25, No. 3, 09.2011, p. 395-400.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hypoalbuminaemia in the perioperative period
T2 - Clinical significance and management options
AU - Neel, Dustin R.
AU - McClave, Stephen
AU - Martindale, Robert
PY - 2011/9
Y1 - 2011/9
N2 - Albumin has been the focus of literally thousands of articles since its first use in the clinical setting during World War II. Despite being at the centre of several clinical controversies, many questions still remain regarding the use and abuse of albumin. The major physiologic functions include maintaining colloid osmotic pressure, binding and transport of metabolically active molecules, serving as an antioxidant, use as a surrogate marker of nutritional status and predictor of outcome in elective surgical populations, having an anti-thrombotic influence on platelets, aiding in acid-base balance and having a protective influence on capillary membrane integrity. Albumin will continue to be widely used in clinical medicine despite many of the drawbacks. It now appears the benefits in the use of albumin in most cases outweigh the risks. The clinical implications of hypoalbuminaemia as an indicator of surgical or intensive care unit (ICU) outcome or nutritional status is clearly disease- and organ specific. The use of albumin as a volume expander appears to have limited, if any, benefit over crystalloid. The "secondary" benefits of albumin in specific surgical and intensive-care conditions, such as sepsis and organ dysfunction, are numerous and are well supported in the current literature.
AB - Albumin has been the focus of literally thousands of articles since its first use in the clinical setting during World War II. Despite being at the centre of several clinical controversies, many questions still remain regarding the use and abuse of albumin. The major physiologic functions include maintaining colloid osmotic pressure, binding and transport of metabolically active molecules, serving as an antioxidant, use as a surrogate marker of nutritional status and predictor of outcome in elective surgical populations, having an anti-thrombotic influence on platelets, aiding in acid-base balance and having a protective influence on capillary membrane integrity. Albumin will continue to be widely used in clinical medicine despite many of the drawbacks. It now appears the benefits in the use of albumin in most cases outweigh the risks. The clinical implications of hypoalbuminaemia as an indicator of surgical or intensive care unit (ICU) outcome or nutritional status is clearly disease- and organ specific. The use of albumin as a volume expander appears to have limited, if any, benefit over crystalloid. The "secondary" benefits of albumin in specific surgical and intensive-care conditions, such as sepsis and organ dysfunction, are numerous and are well supported in the current literature.
KW - albumin
KW - antioxidant
KW - capillary integrity
KW - colloid osmotic pressure
KW - hypoalbuminemia
KW - surrogate nutrition indicator
KW - volume expansion
UR - http://www.scopus.com/inward/record.url?scp=80052985894&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80052985894&partnerID=8YFLogxK
U2 - 10.1016/j.bpa.2011.07.006
DO - 10.1016/j.bpa.2011.07.006
M3 - Article
C2 - 21925404
AN - SCOPUS:80052985894
VL - 25
SP - 395
EP - 400
JO - Bailliere's Best Practice and Research in Clinical Anaesthesiology
JF - Bailliere's Best Practice and Research in Clinical Anaesthesiology
SN - 1521-6896
IS - 3
ER -