D'Angio R G
Presbyterian Healthcare Services, Albuquerque, NM.
Ann Pharmacother. 1994 Apr;28(4):478-82. doi: 10.1177/106002809402800411.
To review the administration of exogenous albumin in patients receiving nutritional support and determine if the use of albumin is supported by controlled trials.
MEDLINE search of English-language literature using the key terms albumin, parenteral nutrition, and enteral nutrition. The references of articles identified were also searched.
Studies examining the administration of exogenous albumin to hypoalbuminemic patients receiving nutrition support.
Results from prospective randomized trials are presented in detail. Data from noncontrolled and animal studies are presented in areas where human controlled trials are limited.
Albumin is a marker of malnutrition and numerous studies have demonstrated that a low serum albumin concentration is associated with increased morbidity and mortality. Investigators have attempted to improve outcome through the administration of exogenous albumin. The results of controlled trials examining exogenous albumin administration have been equivocal. One study demonstrated a significant decrease in overall complications, pneumonia, and sepsis. In two other controlled trials, albumin administration failed to decrease complications. None of the studies demonstrated a significant decrease in mortality or length of stay. A low serum albumin concentration has also been linked to intolerance to enteral feedings. Although case reports and one study support the administration of albumin, two prospective controlled trials have failed to demonstrate improved tolerance to enteral feeding in hypoalbuminemic patients receiving exogenous albumin.
Evidence to date is insufficient to support the routine administration of exogenous albumin to hypoalbuminemic patients receiving nutrition support.
回顾接受营养支持患者的外源性白蛋白应用情况，并确定白蛋白的使用是否有对照试验支持。
使用关键词白蛋白、肠外营养和肠内营养检索MEDLINE英文文献。对已识别文章的参考文献也进行了检索。
研究外源性白蛋白应用于接受营养支持的低白蛋白血症患者的情况。
详细列出前瞻性随机试验的结果。在人体对照试验有限的领域列出非对照研究和动物研究的数据。
白蛋白是营养不良的一个指标，众多研究表明血清白蛋白浓度低与发病率和死亡率增加相关。研究人员试图通过给予外源性白蛋白来改善结局。关于外源性白蛋白应用的对照试验结果并不明确。一项研究显示总体并发症、肺炎和败血症显著减少。在另外两项对照试验中，给予白蛋白未能减少并发症。没有一项研究显示死亡率或住院时间显著降低。血清白蛋白浓度低也与肠内喂养不耐受有关。尽管病例报告和一项研究支持给予白蛋白，但两项前瞻性对照试验未能证明接受外源性白蛋白的低白蛋白血症患者对肠内喂养的耐受性有所改善。
目前的证据不足以支持对接受营养支持的低白蛋白血症患者常规给予外源性白蛋白。
