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Cited by 898Sepsis Diagnosis and TreatmentTrauma, Hemostasis, Coagulopathy, ResuscitationClinical Nutrition and Gastroenterology

INCREASED VASCULAR PERMEABILITY: A MAJOR CAUSE OF HYPOALBUMINAEMIA IN DISEASE AND INJURY

Fleck, A., Hawker, Felicity, Wallace, P.I., Raines, Gail, Trotter, J., Ledingham, I.Mca., Calman, K.C.·1985·The Lancet
DOI 10.1016/s0140-6736(85)91447-3
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Abstract

The rate of loss of albumin to the tissue spaces (measured as transcapillary escape rate) rose by more than 300% in patients with septic shock, and the average increase within 7 h of cardiac surgery was 100%. The transcapillary escape rate in cachectic cancer patients was twice that of a group of healthy individuals. The rate of loss of albumin to the tissue spaces is normally 5%/h, which is more than 10 times the rates of synthesis and catabolism, and these large rate increases indicate that increased vascular permeability is an important cause of the lowered concentration of albumin commonly seen in acute and chronic disease.

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Crossref · 10.1016/s0140-6736(85)91447-3

Cites

24 of 24 references verified0 citation errors · 0 not checkable

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  • Adequately resuscitated patients are maintained in a positive fluid balance of 5-10 liters after clean elective major surgery or other types of trauma.

    “Adequately resuscitated patients are maintained in a positive fluid balance of 5–10 liters after clean elective major surgery or other types of trauma.4”

    From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [4]

  • Other sites, including muscle and adipose tissue in collaboration with the liver and possibly the kidney, release solutes into the vascular compartment from where they enter the interstitium at increased rates, facilitated by increased capillary permeability.

    “Other sites (muscle and adipose tissue in collaboration with the liver and, possibly, the kidney12) release these solutes into the vascular compartment from where they enter the extravascular extracellular compartment (interstitium) at increased rates, also facilitated by the increased capillary permeability.4, 13, 14, 15, 16, 17”

    From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [4]

  • After an initial steep drop, plasma albumin levels continue to decrease modestly until 3-7 days after operation, when they start to increase slowly in the case of clinical recovery.

    “After an initial steep drop, plasma albumin levels continue to decrease modestly until 3–7 days after operation, when they start to increase slowly in the case of clinical recovery.4”

    From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [4]

  • Inflammation increases escape of serum albumin from plasma.

    “Inflammation increases capillary permeability and escape of serum albumin, leading to expansion of interstitial space and increasing the distribution volume of albumin.”

    From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [4]

  • After severe trauma or sepsis, fat-free mass increases by 5-15 liters or even more.

    “However, abundant clinical evidence exists showing that after severe trauma or sepsis, fat‐fee mass increases 5–15 liters or even more.4”

    From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [4]

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Authors
Fleck, A., Hawker, F., Wallace, P. I., Raines, G., Trotter, J., Ledingham, I. M., & Calman, K. C.
Affiliations
Western Infirmary (GB)
Venue
The Lancet
Publisher
Elsevier BV
Published
1985-04
Volume
325
Issue
8432
Pages
781-784
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(85)91447-3
OpenAlex
W2150563200
Cited by
898
References
24
Citations by year
2026: 22 · 2025: 26 · 2024: 37 · 2023: 37 · 2022: 32 · 2021: 51 · 2020: 39 · 2019: 35 · 2018: 26 · 2017: 23 · 2016: 36 · 2015: 34 · 2014: 26 · 2013: 30 · 2012: 24
FWCI
15.13
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Trauma, Hemostasis, Coagulopathy, Resuscitation
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
Keywords
vascular permeability, hypoalbuminemia, transcapillary escape rate, albumin loss, septic shock, cardiac surgery, cachexia, cancer
MeSH terms
Capillary Permeability, Female, Humans, Male, Serum Albumin, Shock, Septic, Surgical Procedures, Operative

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