Correlation Between Serum Albumin
Levels and Ventilator Length of Stay (VLOS) in a Group of Mechanically Ventilated
Pediatric Patients.
Ruben D Restrepo, MD, RRT. Department
of Cardiopulmonary Care Sciences. Georgia State University. Atlanta, GA.
Background: Hypoalbuminemia
is a common finding in critically ill patients. It has been well documented
that hypoalbuminemic patients have a higher morbidity and mortality rate when
compared with patients with a normal serum albumin. However, albumin replacement
to correct hypoalbuminemia in critically ill patients in the hope of improving
their outcome has remained controversial. Since extended Ventilator Length of
Stay (VLOS) has been associated with higher morbidity and mortality, correlation
between the serum albumin levels with the time acutely ill pediatric patients
remain intubated in the intensive care unit can serve as a prognostic marker.
No study has correlated the presence of hypoalbuminemia with the VLOS in mechanically
ventilated pediatric patients.
Objective: To correlate serum
albumin levels and ventilator length of stay in a group of mechanically ventilated
pediatric patients.
Setting: A tertiary pediatric
ICU.
Subjects: Patients admitted
to the PICU between March of 1997 to June of 1998 who underwent mechanical ventilation.
Methods: One hundred mechanically
ventilated pediatric patients were reviewed as part of ongoing research examining
mechanical ventilation weaning in pediatric patients. Serum albumin level was
measured on 64 patients upon admission. Hypoalbuminemia was classified as mild
(2.5 3.5 g/dL) and severe (< 2.5 g/dL).
Outcome Measures: Length
of mechanical ventilation.
Results: A total of 64 charts
of mechanically ventilated pediatric patients were reviewed. Independent t-tests
for equality of means were used to compare VLOS and albumin levels. The mean
(+ SD) serum albumin level for all patients was 3.0 + 0.7 g/dL. The patients
with a serum albumin level of <2.5 g/dL had a mean VLOS of 4.28 + 5.04 days
compared to patients with serum albumin levels between 2.5 and 3.5 g/dL (2.89+
3.6 days), and patients with serum albumin levels >3.5 g/dL (2.39 + 2.84 days).
Conclusions: These data suggests that the presence of hypoalbuminemia upon initiation of
mechanical ventilation in pediatric patients is correlated with a longer ventilator
length of stay (r=-.19 p=0.14). However, a larger sample of patients may be
necessary to show a significant difference between the three groups analyzed.
OF-02-013
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