Study on the role of hypoalbuminemia in assessment Of acid-base status in pediatric intensive care unit

Hypoalbuminemia (serum albumin < 33 gmIL) is cornmon finding incritically ill children. Serum albumin level have significant influence onacid-base interpretation in critical illness through calculation ofanion gapwhich is affected by negativecharge on albumin.Several recent studies in critical ill patients have demonstrated theeffect of hypoalbuminemia in interpretation ofacid-base disturbances andits effect on anion gap.In our study, we aimed to detect, characterize and quantify complexmetabolic acid-base abnormalities using pathophysiologic evaluation ofacid-base balance which takes in account change in independentvariables, PC02, SID and concentration of non-volatile weak acids(mainly albumin) and dependent variables; pH, BE and [HC03”].This study was carried out at Pediatric Intensive Care Unit (PICU),Zagazig University Hospitals in the period from October 2004 to October2005. Our study included 150 critically ill patients whom were admittedin PICU and had disturbances in acid-base status anellor disturbances inserum albumin level, ~ 93 were males (62%) and 57 cases female(38%) and 10 subjects ascontroI.All the study population was subjected to the following:1- History taking.2- Clinical examination.3- Laboratory investigations including:• Arterial blood gases.• Serum electrolytes.• Serum albumin level.In this study, we found that with traditional approaches for detectionof acid-base disturbances, about one-fifth of cases has [HeO)’] and baseexcess within normal level but with pathophysiologic evaluation, wefound that these cases had grave metabolic acid-base disturbances and allof them had hypoalbuminemia.