DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20220764

Study of hypoalbuminemia in paediatric intensive care unit admitted children

Kishan G. Takrani, Suhas G. Kumbhar

Abstract


Background: Albumin has several important properties in both health and disease. Hypoalbuminemia has been considered as an indicator of disease severity and mortality in adult patients, but its role in pediatric patients is not well established. Study aimed to understand importance of hypoalbuminemia in critical illness in paediatric patients.

Methods: This was a cross-sectional study conducted amongst children aged 2 months to 18 years admitted at PICU of a tertiary care hospital over a period of 6 months. Study protocol was approved by institutional ethical committee.

Results: Amongst the total studied cases (110), 59 cases of the total contributed to hypoalbuminemia. According to primary system affected, post COVID MISC, acute infectious diseases, systemic inflammatory disease and sepsis are some of the common conditions associated with higher incidence of hypoalbuminemia. Statistically significant difference was found in this group of population. Amongst the hypo-albuminemic group 59 (53.64%), in mild category there were 42 (38.18%) patients and in severe category there were 17 patients (15.46%).

Conclusions: Hypoalbuminemia is common in patients admitted to the PICU. Post COVID MISC, acute infectious diseases, sepsis and systemic inflammatory diseases are most common conditions associated with it. Hypo-albuminemiais an important indicator of mortality in PICU and serum albumin is a good and reliable indicator for detecting mortality.

 


Keywords


Hypoalbuminemia, Serum albumin level, Mortality, Critically ill children, Post COVID MISC, Sepsis, Systemic inflammatory disease

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References


Kumar S, Arror S, Kini PG, Mundkur S, Moideen A. Hypoalbuminemia as a marker of adverse outcome in children admitted to pediatric intensive care unit. Indian J Child Health. 2017;1-5.

Tiwari LK, Singhi S, Jayashree M, Baranwal AK, Bansal A. Hypoalbuminemia in critically sick children. Indian J Cri Care Med. 2014;18(9):565-9.

Kim YS, Sol IS, Kim MJ, Kim SY, Kim JD, Kim YH et al. Serum Albumin as a biomarker of poor prognosis in the Pediatric Patients in Intensive Care Unit. Korean J Crit Care Med. 2017;32(4):347-55.

Durward A, Mayer A, Skellet S. Hypoalbuminemia in critically ill children: incidence, prognosis and influence on the anion gap. Arch Disease Childhood. 2003;88(5):419-22.

Yap FH, Joynt GM, Buckley TA, Wong EL. Association of serum albumin concentrations and mortality risk in critically ill patients. Ana Intensive care. 2002;30(2):202-7.

Kittisakmontri K, Reungrongrat S, Lao-Araya M. Hypoalbuminemia at admission predicts the poor outcome in critically ill children. Anaesthesiol Intensive Therapy. 2016;48(3),158-61.

Horowitz IN, Tai K. Hypoalbuminemia in critically ill children. Arch Pediatr Adoles Med. 2007;161(11):1048-1052.

Jellinge ME, Henriksen DP, Hallas P, Brabrand M, Hypoalbuminemia is a strong predictor of 30 day all-cause mortality in acutely admitted medical patients. A Prospective, Observational, Cohort study. Plos One. 2014;9(8):e105983.

Akirov A, Masri-Iraqi H, Atamna A, Shimon I. Low Albumin Levels are associated with Mortality Risk in Hospitalised Patients. Am J Med. 2019;130(12):1465.e11-9.

Moustafa AA, Halawany ASA, Rafa MF. Evaluation of hypoalbuminemia as a predictor of clinical outcome in critically ill children in Alexandria University Children’s hospital. J Med Sci Clin Res. 2018;6(1):32299-306.

Deka A, Debnath S K, Teronpi I, Ganguly A. Study on the prevalence of hypoalbuminemia and their clinical outcome in critically ill children admitted to PICU in tertiary care hospital. J Med Sci Clin Res. 2020;8(1):862-7.

Yanni GN, Lubis M, Ali M. The Influence of Albumin level in Critically Ill Children to Length of Stay and Mortality in Pediatric Intensive Care Unit. Open access Macedo J Med Sci. 2019;7(20):3455-8.

Nicholson JP, Wolmarans MR, Park GR. The role of albumin in critical illness. British Journal of Anaethesia. 2000;85(4):599-610.

Soeters PB, Wolfe RR, Shenkin A. Hypoalbuminemia: Pathogenesis and Clinical significance. J Parenteral enteral nutr. 2019;43((2):181-9.

Caironi P, Gattinoni L. The clinical use of albumin: the point view of specialist in intensive care. Blood transfusion. Transfusion del Sangue. 2009;7(4):259-67.