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Crit Care Med. 1992 Feb;20(2):164-9.

Effect of hypoalbuminemia and parenteral nutrition on free water excretion and electrolyte-free water resorption.

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1
Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee, Memphis 38163.

Abstract

OBJECTIVE:

To measure the effect of human albumin supplementation during parenteral nutrition on serum albumin concentrations, colloid oncotic pressure, free water clearance, electrolyte-free water resorption, and sodium excretion.

DESIGN:

Prospective, randomized, controlled trial.

SETTING:

Tertiary care center.

PATIENTS:

Thirty adult, hypoalbuminemic patients who required parenteral nutrition.

INTERVENTIONS:

Parenteral nutrition (control) or parenteral nutrition plus human albumin 25 g/L as a continuous infusion (treatment) for a 5-day study period.

MEASUREMENTS:

On days 1 and 5, serum albumin concentration, colloid oncotic pressure, free water clearance, electrolyte-free water resorption, and sodium excretion were measured.

RESULTS:

Serum albumin concentrations increased significantly from day 1 to day 5 in both groups (control: 2.0 +/- 0.1 [mean +/- SEM] vs. 2.3 +/- 0.1 g/dL [20 +/- 1 vs. 23 +/- 1 g/L], p = .02; treatment: 2.2 +/- 0.1 vs. 3.5 +/- 0.2 g/dL [22 +/- 1 vs. 35 +/- 2 g/L], p = .0001). Day 5 serum albumin concentrations were significantly higher in the treatment group compared with control (p = .0001). Colloid oncotic pressure increased significantly from day 1 to day 5 in the treatment group (17.8 +/- 0.8 vs. 25.1 +/- 1.0 mm Hg, p = .0001), and was significantly higher than control at day 5 (p = .0001). No significant differences were found for free water clearance, electrolyte-free water resorption, or sodium excretion within or between groups.

CONCLUSIONS:

In hypoalbuminemic patients, human albumin supplementation during parenteral nutrition results in significant increases in serum albumin concentrations and colloid oncotic pressure, but has no apparent effect on free water clearance, electrolyte-free water resorption, or sodium excretion.

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