hypoalbuminemia is a bad prognostic marker for the patients undergoing emergency GI surgery. studies has shown that its levels may further fall down in the immediate post op period as early as 06 hrs. so shouldnt it be beneficial to supplement the human albumin in the immediate post op period ?
Indications for the use of albumin
Major surgery Albumin should not be used in the immediate post-operative period.2C+ Only indication for use: serum albumin < 2 g/dL after normalisation of circulatory volume.
The use of albumin may be indicated in subjects undergoing major surgery (> 40% resection of the liver, extensive intestinal resection) when, after normalisation of circulatory volume, the serum albumin is < 2 g/dL (Grade of recommendation 2C+)
The use of albumin in the immediate post-operative period is never advised for any other type of operation.
Paracentesis5 g of albumin/L ascitic fluid removed, after paracentesis of volumes > 5 L.1C+
Therapeutic plasmapheresisFor exchanges of > 20 mL/kg in one session or > 20 mL/kg/week in more than one session.2C+
Spontaneous bacterial peritonitisIn association with antibiotics.1C+
Occasionally appropriate indications (when other criteria are fulfilled)Heart surgeryLast-choice treatment after crystalloids and non-protein colloids.2C+
Major surgery Albumin should not be used in the immediate post-operative period.2C+ Only indication for use: serum albumin < 2 g/dL after normalisation of circulatory volume.
Cirrhosis of the liver with refractory ascitesGenerally ineffective, except in patients with serum albumin < 2 g/dL.2C
Ref:
Recommendations for the use of albumin and immunoglobulins
Giancarlo Liumbruno, Francesco Bennardello, [...], and Gina Rossettias
we use albumin almost only in large liver resection In acute pancreatitis for. example can be dangerous increasing lung damage
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