Dynamics of Albumin Synthetic Response to Intra-Abdominal Abscess in Patients with Gastrointestinal Fistula
Open accessAbstract
Background: Low serum albumin concentration is a predictor of failure of source control for intra-abdominal infection. However, data on dynamics of albumin synthesis in these patients and to what extent these changes contribute to hypoalbuminemia are relatively scarce. We investigated in a group of patients with gastrointestinal fistula the dynamic response of liver albumin synthesis to intra-abdominal abscess and how these related to hypoalbuminemia and circulating endocrine hormone profiles. Methods: Eight gastrointestinal fistula patients scheduled to undergo percutaneous abscess sump drainage were enrolled prospectively to measure albumin synthesis rates at different stages of the inflammatory response (immediately after diagnosis and 7 d following sump drainage when clinical signs of intra-abdominal sepsis had been eradicated). Eight age-, sex-, and body mass index–matched intestinal fistula patients were studied as control patients. Consecutive arterial blood samples were drawn during a primed-constant infusion (priming dose: 4 micromol·kg −1 , infusion rate: 6 micromol·kg −1 ·min −1 ) to determine the incorporation rate of L-[ ring - 2 H 5 ]-phenylalanine directly into plasma albumin using gas chromatography/mass spectrometry analysis. Results: Patients suffering from intra-abdominal infection had reduced plasma albumin and total plasma protein concentrations, compared with control patients. Albumin fractional synthesis rates in patients with intra-abdominal abscess were decreased, compared with those in the control group. When the source of infection was removed, albumin synthesis rates returned to control values, whereas albumin concentrations did not differ significantly from the corresponding concentrations in control subjects and patients with intra-abdominal abscess. Conclusion: Despite nutritional intervention, albumin synthesis rate is decreased in intestinal fistula patients with intra-abdominal abscess; albumin synthesis returns to control values during convalescence.
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In intestinal fistula patients with intra-abdominal abscesses, serum albumin synthesis rate was found to be decreased.
“In intestinal fistula patients with intra‐abdominal abscesses, serum albumin synthesis rate was found to be decreased.78”
From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [78]
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Self-citation
- Authors
- Zhou, B., Ren, J., Han, G., Chen, Y., A, J., Gu, G., Chen, J., Wang, G., & Li, J.
- Affiliations
- Nanjing General Hospital of Nanjing Military Command (CN)
- China Pharmaceutical University
- Corresponding author
- Ren, Jianan
- Venue
- Surgical Infections
- Publisher
- SAGE Publications
- Published
- 2014-01-24
- Volume
- 15
- Issue
- 2
- Pages
- 111-117
- ISSN
- 1096-2964 (ISSN-L)
- 1557-8674
- PMC
- PMC3993077
- OpenAlex
- W23679975
- Cited by
- 7
- References
- 31
- Citations by year
- 2022: 1 · 2021: 1 · 2020: 1 · 2018: 1 · 2016: 1 · 2015: 2
- FWCI
- 0.80
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Surgical Infections (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (BK2010017, 30872456)
- Government of Jiangsu Province
- Natural Science Foundation of Jiangsu Province
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Abdominal Surgery and Complications
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Keywords
- hypoalbuminemia, intra-abdominal abscess, gastrointestinal fistula, intestinal fistula, hepatic protein synthesis, phenylalanine incorporation, percutaneous abscess drainage, source control, abdominal sepsis
- MeSH terms
- Adult, Albumins, Female, Humans, Male, Triiodothyronine, Case-Control Studies, Digestive System Fistula, Abdominal Abscess, Hypoalbuminemia
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