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Analysis of post-operative hypalbuminaemia: a clinical study
H J Smeets1, J Kievit, F T Dulfer
1Department of General Surgery, Universitu Hospital Leiden, The Netherlands.
Objective:
Analysis of severity, causes and relevance of hypalbuminaemia developing after surgery.
Subjects:
Patients undergoing elective aortic surgery (n = 11) or minor extra-abdominal surgery (n = 6).
Methods:
Serum albumin concentration, blood loss, nitrogen balance and complications were determined until the fifth post-operative day. The contributions of haemodilution, albumin loss, albumin catabolism and redistribution were calculated using existing formula. The relation of hypalbuminaemia to the endocrine-metabolic response was determined.
Results:
Significant hypalbuminaemia occurred after aortic surgery, in the absence of significant complications. No haemodilution occurred. Analysis indicated that 18% of hypalbuminaemia was caused by blood loss. Only 6% could be attributed to albumin catabolism, despite a significant correlation with the endocrine-metabolic response. Seventy-seven percent of hypalbuminaemia was attributed to albumin redistribution. No hypalbuminaemia occurred after minor surgery.
Conclusion:
Post-operative hypalbuminaemia is a normal finding early after aortic surgery. It is mainly caused by albumin redistribution, not by metabolic changes.
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