Abstract: Albumin plasma concentrations are being used as an indicator of
nutritional status and hepatic function, based on the assumption that
plasma levels reflect its rate of synthesis. However, it has been shown
that albumin levels are not reliable markers of albumin synthesis under a
variety of clinical conditions including inflammation, malnutrition,
diabetes mellitus, liver disease and surgical tissue trauma.
To date, only a few studies have measured albumin synthesis in surgical
and critically ill patients. This review summarizes the findings from
these studies which used different tracer methodology in various surgical
or critically ill patient populations.
The results indicate that the fractional synthesis rate of albumin
appears to decrease during surgery, followed by an increase during the
postoperative phase. In the early postoperative phase, albumin fractional
synthesis rate can be stimulated by perioperative nutrition, if enough
amino acids are being provided and if nutrition is being initiated before
the operation. The physiologic meaning of albumin synthesis after
surgery, however, still needs to be further clarified.