Hypoalbuminaemia in the perioperative period: Clinical significance and management options

Dustin R. Neel, Stephen McClave, Robert Martindale

Research output: Contribution to journalReview article

20 Scopus citations

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 languageEnglish (US)
Pages (from-to)395-400
Number of pages6
JournalBest Practice and Research: Clinical Anaesthesiology
Volume25
Issue number3
DOIs
StatePublished - Sep 2011

Keywords

  • albumin
  • antioxidant
  • capillary integrity
  • colloid osmotic pressure
  • hypoalbuminemia
  • surrogate nutrition indicator
  • volume expansion

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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