Serum albumin concentrations: who needs them?
OBJECTIVE
To examine the multiple factors that influence serum albumin concentrations and to discuss settings in which the monitoring of such concentrations provides clinically useful information.


METHODS
Original investigations, review articles, books, and abstracts published in English.


METHODS
Studies pertaining to factors affecting serum albumin concentration were chosen based on general applicability. Recommendations related to the appropriate monitoring of albumin concentrations were based on studies performed in the clinical setting with direct applicability to patient care.


METHODS
Data on factors affecting serum albumin concentration were extracted from studies that resulted in similar conclusions regardless of assay technique. Appropriate indications for albumin monitoring were derived from studies demonstrating direct clinical relevance.


RESULTS
A number of factors may influence serum albumin concentration and ultimately affect interpretation of the concentration. Serum albumin concentrations generally are useful in the institutional setting shortly after admission or preoperatively to determine patient prognosis. Albumin concentrations have limited merit for predicting the free fractions of various hormones, electrolytes, and drugs. When used as an indicator of nutritional support, albumin concentrations are most helpful when measured over longer periods in relatively stable patients.


CONCLUSIONS
Serum albumin determinations should be limited to those situations in which the concentrations are likely to provide clinically useful information. Such situations are limited.
Erstad
B L
BL
Department of Pharmacy Practice, College of Pharmacy, University of Arizona, Tucson 85721.
D001961:Bromcresol Green; D001962:Bromcresol Purple; D006801:Humans; D011237:Predictive Value of Tests; D011379:Prognosis; D012709:Serum Albumin / Q000032:analysis*
D012709:Serum Albumin; D001962:Bromcresol Purple; D001961:Bromcresol Green