A Study of Hypoalbuminemia in Critically ill Children in Pediatric Intensive Care Unit

The aim was to study the incidence of hypoalbuminemia and its effect on outcome in critically ill-children in PICU.

This observational study was conducted in KIMS Hospital, Bangalore, Karnataka, to study the incidence of hypoalbuminemia and its association with the duration of stay in PICU from 1st JULY 2014 to 31 December 2014. 104 cases aged 1 month-18 years admitted to PICU during this period were enrolled in this study. Patients with hypoalbuminemia on admission or any time during PICU stay were compared with normoalbuminemic patients for demographic and clinical profile.

Of the 104 patients admitted during the study period, four patients were excluded (three cases of nephrotic syndrome and one case of chronic liver disease). Hypoalbuminemia was present on admission in 19.23% (20 of 104) patients. After excluding 4 patients, incidence is 19%(19 out of 100) Mean albumin level of studied population was 2.86 g/dL (SD 0.64); 2.00 g/dL (SD 0.33) in hypoalbuminemic group, while 3.24 g/dL (SD 0.55) in normoalbuminemia group (P < 0.001). Mean age, weight and sex ratio in both groups was matched. Of 104 patients, 39 (37.5%) had malnutrition (weight below 80% of expected for their age) with similar distribution in hypoalbuminemic and normoalbuminemic groups. The hypoalbuminemia group had a longer average stay in the PICU (7.02 vs 4.2 days) and the hospital (10.54 vs 5.7 days) than did the normal albumin level group. The hypoalbuminemia group had a lower survival rate.

Hypoalbuminemia is a significant indicator of mortality and morbidity in critically ill children. Hence it is necessary to do albumin levels in all critically ill children.