We evaluated the trend of change or percentage of change of albumin with in 72 hours of intubation in critically ill patients with respiratory failure.
We prospectively evaluated 33 consecutive patients with respiratory failure admitted to a intensive care unit over a four month period. Simplified Acute physiology score (SAPS II) score was calculated at admission, albumin monitored every twenty four hours for three days. Hospital and Intensive care length of stay and number of days of intubation were noted.
33 patients were included in our study (See Table 1). Eight patients died and five became ventilator dependent. The average hospital stay was 17.2 days, while the average ICU stay was 9.3 days and patients were intubated in average for 9.2 days.Albumin level decreased during the first 72 hours in all but one patient. In first 24 hours albumin level had a 18.47% drop, albumin continued to decrease in day two and three by 21.8% and 23.7% respectively. The average albumin reduction was greatest in first 24 hours by 0.61grams/deci-liter (g/dL) and continued to decrease further in day two and three by 0.72 g/dL and 0.79 g/dL respectively. (See table 2) Further analysis was made to see if the change of albumin played a role in outcome and length of stay. While a trend of greater delta albumin and greater percentage change of albumin was present, it was not statistically significant.
There is a decline of albumin level in newly intubated critically ill patients, most prominant in first 24 hours. Albumin monitoring alone in this population may not be prognostic predictor of outcome; however, more studies need to be performed.
There is a significant drop in albumin level with in twenty four hours of intubation. Respiratory failure may affect albumin level and has potential for predictor of outcome.
Farzin Rahmanou, No Financial Disclosure Information; No Product/Research Disclosure Information