title: The incidence of diarrhea in patients with hypoalbuminemia due to acute or chronic malnutrition during enteral feeding.
abstract: OBJECTIVE
  Critically ill patients usually have hypoalbuminemia. The incidence of diarrhea in patients with hypoalbuminemia receiving enteral nutrition was studied.
  
  
  METHODS
  One hundred and ninety-eight patients with serum albumin level below 3 g/dl in the Burn Unit and Nutritional Support Service were retrospectively studied. Diarrhea was defined as liquid or loose stool at least three times a day with a daily volume of more than 300 g for at least 2 days. Most patients in the Burn Unit had acute or subacute onset of hypoalbuminemia, and most patients who were referred to the Nutritional Support Service had a chronic onset of hypoalbuminemia. The patients whose diarrhea were due to formula-related factors, administration techniques, or concomitant drug therapy were excluded.
  
  
  RESULTS
  The results showed that 27% of the patients with albumin levels less than 2 g/dl had diarrhea, but only 10.5% of patients with albumin levels higher than 2 g/dl had diarrhea; the difference was significant. Diarrhea occurred in 35.1% of the patients with chronic development of hypoalbuminemia, but only 9.9% of the patients with rapid development of hypoalbuminemia had diarrhea; that difference also was significant.
  
  
  CONCLUSIONS
  We concluded that the hypoalbuminemia-related diarrhea during tube feeding was significantly higher in patients with albumin levels less than 2 g/dl, and the patients with hypoalbuminemia due to chronic malnutrition had a significantly higher incidence of diarrhea than those with acute malnutrition, such as burned patients.
authors.affiliation: Nutritional Support Service, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan, Republic of China.
authors.forename: T L
authors.initials: TL
authors.lastname: Hwang
authors.forename: M C
authors.initials: MC
authors.lastname: Lue
authors.forename: Y J
authors.initials: YJ
authors.lastname: Nee
authors.forename: Y Y
authors.initials: YY
authors.lastname: Jan
authors.forename: M F
authors.initials: MF
authors.lastname: Chen
mesh_terms: D000208:Acute Disease; D002056:Burns / Q000628:therapy; D002908:Chronic Disease; D016638:Critical Illness; D003967:Diarrhea / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D004750:Enteral Nutrition; D005526:Food, Formulated; D006801:Humans; D015994:Incidence; D011502:Protein-Energy Malnutrition / Q000097:blood* / Q000628:therapy; D012189:Retrospective Studies; D012709:Serum Albumin / Q000172:deficiency*
chemical_list: D012709:Serum Albumin