Govt Medical College, Kota.
J Assoc Physicians India. 2022 Apr;70(4):11-12.
Albumin is the most abundant plasma protein in humans. It works to maintain the colloid oncotic pressures, acts as a carrier protein, and is involved in metabolism, antioxidant, and various other functions. Patients who are admitted to the Intensive Care Unit (I.C.U.) are at an increased risk of mortality due to the severity of their illness. It is thus, important to identify patients at the time of admission who are likely to have a poor outcome so that such patients can be managed aggressively. Serum Albumin appears to be one such prognostic indicator. Its utility as a prognostic indicator has been studied in various contexts including critically ill patients. A low serum albumin concentration correlates with the increase in length of stay in ICU, increasing the risk of death and frequent readmission. The daily trend of serum albumin can be a useful tool in predicting the weaning capability of patients needing mechanical ventilation.
The study was conducted on 100 adult patients of both sexes who are critically ill admitted in the emergency wards and ICU unit in the GMC Kota were included in the study Inclusion Criteria: Critical ill patients will be defined as those who either have multi-organ dysfunction and/or sepsis, need ventilatory support, and required intensive care.
Chronic liver failure, Nephrotic syndrome/chronic kidney disease, Protein-losing enteropathy, Chronic malnutrition.
It was observed during the study that the mean age of the study population was 54.5years. The mean age in survivors was 49.6 years. The mean age in non-survivors was 62.3 years. There was a significant difference (p = 0.0024) between the two groups indicating a higher age at admission for non-survivors. The total decline in serum albumin in the survivors from admission to day10 is 0.75 g/dl. In nonsurvivors, it is 1.07 g/dl over a period of 10 days. The fall in nonsurvivors is steeper than survivors. It suggests that the rapidity with which serum albumin level falls has an effect on the prognosis of the patient in terms of mortality. A steep decline in serum albumin indicates a poor prognosis.
The result shows that serial measurement of serum albumin can accurately predict the outcome. Survivors had significantly higher serum albumin levels all day compared to non-survivors. Serum albumin is routinely measured in all patients and it is a cheap and easily available test facility in all laboratories.
白蛋白是人体中最丰富的血浆蛋白。它的作用是维持胶体渗透压，作为载体蛋白，并参与代谢、抗氧化和各种其他功能。入住重症监护病房（ICU）的患者由于病情严重，死亡率增加。因此，重要的是在入院时识别可能预后不良的患者，以便对这些患者进行积极治疗。血清白蛋白似乎是一种这样的预后指标。它在各种情况下的预后指标的作用已经在包括危重病患者的情况下进行了研究。血清白蛋白浓度低与 ICU 住院时间延长相关，增加了死亡和频繁再入院的风险。血清白蛋白的日常趋势可以成为预测需要机械通气的患者脱机能力的有用工具。
该研究纳入了 100 名成年男女危重病患者，这些患者分别在哥打公立医院的急诊病房和 ICU 病房就诊。纳入标准：危重病患者定义为有多个器官功能障碍和/或脓毒症、需要通气支持和需要重症监护的患者。
慢性肝功能衰竭、肾病综合征/慢性肾脏病、蛋白丢失性肠病、慢性营养不良。
在研究过程中，观察到研究人群的平均年龄为 54.5 岁。幸存者的平均年龄为 49.6 岁。非幸存者的平均年龄为 62.3 岁。两组之间存在显著差异（p = 0.0024），表明非幸存者入院时年龄较大。幸存者从入院到第 10 天的血清白蛋白总下降量为 0.75 g/dl。在非幸存者中，10 天内下降了 1.07 g/dl。非幸存者的下降幅度比幸存者更陡峭。这表明血清白蛋白水平下降的速度对患者的死亡率预后有影响。血清白蛋白迅速下降表明预后不良。
结果表明，连续测量血清白蛋白可以准确预测结果。幸存者全天的血清白蛋白水平明显高于非幸存者。血清白蛋白在所有患者中常规测量，它是所有实验室都有且廉价易得的检测设施。
