[Exogenous human albumin supplementation in total parenteral nutrition of critically ill newborns].
OBJECTIVE
In view of the controversies found in the literature, the present study was conducted to determine the effect of the use of exogenous human albumin on the nutritional status of newborn infants submitted to total parenteral nutrition.


METHODS
Thirty critically ill newborn infants weighing less than 2,500 g were divided into two groups: 15 infants receiving total parenteral nutrition without human albumin (C control group) and 15 with human albumin (group A). Total protein, albumin, prealbumin, and retinol-binding protein were determined at the beginning (3-4 days of postnatal age) and at the end of the study (10-11 days of postnatal age). On the seventh day of the study, nitrogen balance (retention) was measured. The following clinical parameters were evaluated: weight, age at the beginning of enteral nutrition, time to reach a full enteral volume, length of stay in the intensive care unit, total hospitalization time, and mortality.


RESULTS
The results showed a significant difference (p < 0.05) in serum albumin and total protein levels (p < 0.05) between groups at the end of the study. Median albumin levels were 2.95 g/dl in group C (2.71-3.16 g/dl), whereas group A showed median albumin levels of 4.10 g/dl, (3.76-4.66 g/dl). Total protein levels were 4.9 g/dl (4.4-5.2 g/dl) and 5.6 g/dl (5.5-6.3 g/dl), respectively, with no repercussions on any of the remaining parameters evaluated.


CONCLUSIONS
On the basis of the results obtained in the present study, no benefits were derived from the use of human albumin in total parenteral nutrition in severely ill newborns; therefore its use cannot be recommended, unless the objective is exclusively to elevate albumin levels.
Porto
Beatriz S S
BS
Departamento de Pediatria e Puericultura, Universidade Federal de Santa Maria, Santa Maria, RS. biaporto@yahoo.com
Jorge
Salim M
SM
de Assis
Maria Graças Elias
MG
D000418:Albumins / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016638:Critical Illness / Q000628:therapy*; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D009584:Nitrogen / Q000032:analysis* / Q000378:metabolism; D009752:Nutritional Status; D010289:Parenteral Nutrition, Total / Q000379:methods*; D012709:Serum Albumin / Q000032:analysis; D013997:Time Factors
D000418:Albumins; D015415:Biomarkers; D012709:Serum Albumin; D009584:Nitrogen