Albumin Use and Its Association with Nutritional Status in the Intensive Care Unit : A Narrative Review
DOI:
https://doi.org/10.24843/JATI.2025.v01.i02.p08Kata Kunci:
albumin, critical ill, Hipoalbuminemia, Intensive Care Unit, Nutritional StatusAbstrak
Introduction: Albumin is the major protein in blood plasma that plays a pivotal role in the regulation of oncotic pressure and nutritional status, particularly in critically ill patients. Hypoalbuminemia is frequently observed in ICU patients and is associated with increased morbidity and mortality. This narrative review aims to assess the role and efficacy of albumin supplementation, administered both orally and intravenously, in supporting the nutritional status and prognosis of critically ill patients.
Methods: A literature search was conducted across the PubMed, Google Scholar, ScienceDirect, and ProQuest databases utilizing the keywords: "albumin", "critical illness", "nutrition", and "ICU". Articles included were those published within the last 10 years, available in English and Indonesian, and comprised review articles, clinical trials, and clinical practice guidelines. The selection process was performed through the screening of titles, abstracts, and subsequent full-text reviews. A total of 23 articles were included in this review.
Results: The literature indicates that albumin supplementation contributes to hemodynamic stability, a reduction in nosocomial infections, and improved prognosis in patients with conditions such as sepsis, ARDS, hepatic and renal dysfunction, and in post-operative states. Supplementation with snakehead fish (Channa striata) extract has also been reported to increase albumin levels. Accurate nutritional assessment, using tools like the Nutrition Focused Physical Exam (NFPE), Subjective Global Assessment (SGA), and biomarkers such as Total Lymphocyte Count (TLC) and Neutrophil to Lymphocyte Ratio (NLR) are essential for determining the nutritional status of critically ill patients. Specific recommendations from the ESPEN consensus and various hepatology and nephrology associations exist concerning the application of albumin in specific clinical conditions.
Conclusion: Albumin supplementation holds significant potential in supporting the nutritional status and improving the clinical outcomes of critically ill patients. Further studies are required to determine optimal protocols and the cost-effectiveness of albumin therapy in the critically ill patient population.
Unduhan
Referensi
1. Allison SP, Lobo DN. The clinical significance of hypoalbuminaemia. Clin Nutr. 2024;43(4):909–14.
2. Melia D, Post B. Human albumin solutions in intensive care: A review. J Intensive Care Soc. 2021;22(3):248–54.
3. Schneider F, Dureau A, Helle S, Betscha C, Cremel G, Senger B. A Pilot Study on Continuous Infusion of 4% Albumin in Critically Ill Patients: Impact on Nosocomial Infection via a Reduction Mechanism for Oxidized Substrates. Crit Care Explor. 2019;1:9.
4. Soeters P, Wolfe R, Shenkin A. Hypoalbuminemia: Pathogenesis and Clinical Significance. J Parenter Enter Nutr. 2019;43(2):181–93.
5. Hryciw N, Joannidis M, Hiremath S. Intravenous Albumin for Mitigating Hypotension and Augmenting Ultrafiltration during Kidney Replacement Therapy. CJASN. 2021;16(5):820–8.
6. Saner F, Stueben B, Hoyer D, Broering D, Bezinover D. Use or Misuse of Albumin in Critical Ill Patients. Diseases. 2023;11(2):68.
7. Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr [Internet]. 2019;38(1):48–79. Available from: https://doi.org/10.1016/j.clnu.2018.08.037
8. Muryawan MH, Soemantri A, Subagio HW, Sekarwana N. Pengaruh Suplementasi Ekstrak Ikan Gabus (Channa Striata ) Terhadap Kadar Albumin, Kolesterol, Waktu Remisi Dan Kejadian Relaps Pada Anak Sindrom Nefrotik. Medica Hosp J Clin Med. 2019;6(1):7–12.
9. Mulyana R, Setiati S, Martini RD, Harimurti K. the Effect of Ophiocephalus Striatus Extract on Tnf‐Α and Tgf‐Β1 Levels, Dlco, and Qol in Stable Copd Patients With Muscle Wasting. Respirology. 2017;22(S3):175–6.
10. Finfer S, McEvoy S, Bellomo R, McArthur C, Myburgh J, Norton R, et al. Impact of albumin compared to saline on organ function and mortality of patients with severe sepsis. Intensive Care Med. 2011;37(1):86–96.
11. Joannidis M. Albumin Replacement in Severe Sepsis or Septic Shock. N Engl J Med. 2014;371(1):80–3.
12. Sort P, Navasa M, Arroyo V, Aldeguer X, Planas R, Ruiz-del-Arbol L. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis. 1999;403–9.
13. Moore KP, Aithal GP. Guidelines on the management of ascites in cirrhosis. Gut. 2006;55(SUPPL. 6):1–12.
14. Salerno F, Navickis RJ, Wilkes MM. Albumin treatment regimen for type 1 hepatorenal syndrome: A dose-response meta-analysis. BMC Gastroenterol [Internet]. 2015;15(1):1–11. Available from: http://dx.doi.org/10.1186/s12876-015-0389-9
15. Gerbes et al. Aktualisierte S2k-Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) „Komplikationen der Leberzirrhose“. Z Gastroenterol. 2019;57(05):e168–e168.
16. Macedo E, Karl B, Lee E, Mehta RL. A randomized trial of albumin infusion to prevent intradialytic hypotension in hospitalized hypoalbuminemic patients. Crit Care [Internet]. 2021;25(1):1–8. Available from: https://doi.org/10.1186/s13054-020-03441-0
17. O’Brien Z, Finnis M, Gallagher M, Bellomo R. Early Treatment with Human Albumin Solution in Continuous Renal Replacement Patients. Blood Purif. 2021;50(2):205–13.
18. Yu YT, Liu J, Hu B, Wang RL, Yang XH, Shang XL, et al. Expert consensus on the use of human serum albumin in critically ill patients. Chin Med J (Engl). 2021;134(14):1639–54.
19. Wengenmayer T, Schroth F, Biever PM, Duerschmied D, Benk C, Trummer G, et al. Albumin fluid resuscitation in patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) therapy is associated with improved survival. Intensive Care Med [Internet]. 2018;44(12):2312–4. Available from: https://doi.org/10.1007/s00134-018-5443-y
20. Acharya P, Jakobleff WA, Forest SJ, Chinnadurai T, Mellas N, Patel SR, et al. Fibrinogen Albumin Ratio and Ischemic Stroke during Venoarterial Extracorporeal Membrane Oxygenation. ASAIO J. 2020;66(3):277–82.
21. Rocha NP, Fortes RC. Total lymphocyte count and serum albumin as predictors of nutritional risk in surgical patients. Arq Bras Cir Dig. 2015;28(3):193–6.
22. Martin GS, Moss M, Wheeler AP, Mealer M, Morris JA, Bernard GR. A randomized, controlled trial of furosemide with or without albumin in hypoproteinemic patients with acute lung injury. Crit Care Med. 2005;33(8):1681–7
Unduhan
Diterbitkan
Terbitan
Bagian
Lisensi
Hak Cipta (c) 2025 Putu Eka Nantha Kusuma, Jeremy Jonathan, Putu Agus Surya Panji (Author)

Artikel ini berlisensi Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal the right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY 4.0) that allows others to share, use, distribute, and reproduce the work in any medium, provided the original author and source are properly credited.



