Effect of exogenous albumin infusion on acute phase proteins in pediatric burns

Theresa Mayes, Michele Gottschlich, Marilyn Jenkins, Jane Khoury, David G Greenhalgh, Glenn Warden

Research output: Contribution to journalArticle

Abstract

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 languageEnglish (US)
JournalCritical Care Medicine
Volume27
Issue number1 SUPPL.
StatePublished - 1999
Externally publishedYes

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Acute-Phase Proteins
Burns
Albumins
alpha-Macroglobulins
Orosomucoid
alpha 1-Antitrypsin
Pediatrics
Proteins
Retinol-Binding Proteins
Ceruloplasmin
Prealbumin
Wounds and Injuries
Chi-Square Distribution
Transferrin
Resuscitation
Serum Albumin
Inhalation
Blood Proteins
Shock
Sepsis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Mayes, T., Gottschlich, M., Jenkins, M., Khoury, J., Greenhalgh, D. G., & Warden, G. (1999). Effect of exogenous albumin infusion on acute phase proteins in pediatric burns. Critical Care Medicine, 27(1 SUPPL.).

Effect of exogenous albumin infusion on acute phase proteins in pediatric burns. / Mayes, Theresa; Gottschlich, Michele; Jenkins, Marilyn; Khoury, Jane; Greenhalgh, David G; Warden, Glenn.

In: Critical Care Medicine, Vol. 27, No. 1 SUPPL., 1999.

Research output: Contribution to journalArticle

Mayes, T, Gottschlich, M, Jenkins, M, Khoury, J, Greenhalgh, DG & Warden, G 1999, 'Effect of exogenous albumin infusion on acute phase proteins in pediatric burns', Critical Care Medicine, vol. 27, no. 1 SUPPL..
Mayes, Theresa ; Gottschlich, Michele ; Jenkins, Marilyn ; Khoury, Jane ; Greenhalgh, David G ; Warden, Glenn. / Effect of exogenous albumin infusion on acute phase proteins in pediatric burns. In: Critical Care Medicine. 1999 ; Vol. 27, No. 1 SUPPL.
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T1 - Effect of exogenous albumin infusion on acute phase proteins in pediatric burns

AU - Mayes, Theresa

AU - Gottschlich, Michele

AU - Jenkins, Marilyn

AU - Khoury, Jane

AU - Greenhalgh, David G

AU - Warden, Glenn

PY - 1999

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N2 - 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.

AB - 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.

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