Introduction: Acute phase proteins are often used as nutritional or prognostic indicators following bum injury. The effect of exogenous albumin administration on serum visceral proteins: albumin (ALB), total protein (TP), transferrin, prealbumin, retinol-binding protein, IgG, C3, ceruloplasmin, alpha 1-antitrypsin (AAT), alpha 1-acid glycoprotein (AAG), alpha 2-macroglobulin (AMG) and c-reactive protein was evaluated in a subset of pediatric patients with ≥ 40% TBSA burns. Methods: The treated (TX) group was randomized to receive supplemental albumin necessary to maintain serum levels between 2.5 - 3.5 gm/dL (n=22) and the untreated (NOTX) group was provided exogenous albumin only if levels dropped below 1.5 gm/dL (n=22). Study protocol commenced when the burn shock resuscitation period ended. Data were examined using Chi-square, t-test, and multivariate analysis using a nested mixed model. Results: Both groups were similar in size of TBSA bum, % 3rd, age, inhalation injury and calorie and protein intake. Incidence of death in the TX and NOTX groups was 36% vs 14% ,respectively(p<0.08). Pneumonia (p<0.001) and sepsis (p<0.03) were higher in the TX group. Serum levels of ALB and TP were significantly higher in the supplemented group. Multivariately, differences were noted between the TX and NOTX groups for AAT, AAG, and AMG. Subsequent univariate analysis revealed: significantly lower levels of AAT in the TX group weeks 2,3,4, (p<0.001); decreased levels of AAG for weeks 2 and 3 (p<0.02); and significantly lower levels of AMG for week 1 (p<0.01). Conclusion: Exogenous albumin administration has an inverse impact on select acute phase proteins in pediatric bums. The mechanism involved in these changes remains to be elucidated.
|Original language||English (US)|
|Journal||Critical Care Medicine|
|Issue number||1 SUPPL.|
|State||Published - 1999|
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine