2002 OPEN FORUM Abstracts
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.