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Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) ›› 2022, Vol. 08 ›› Issue (04): 295-298. doi: 10.3877/cma.j.issn.2096-1537.2022.04.003

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Plasma visceral proteins in nutritional assessment of critically ill patients

Chengrui Zhu1, Xiaochun Ma1, Ran Zhu1,()   

  1. 1. Department of Critical Care Medicine, the First Affiliated Hospital, China Medical University, Shenyang 110001, China
  • Received:2022-10-14 Online:2022-11-28 Published:2023-02-07
  • Contact: Ran Zhu

Abstract:

Plasma visceral proteins are mostly synthesized by the liver and are traditional biomarkers for nutritional assessment. During stress response and inflammatory states in critically ill patients, as negative acute phase reactive proteins, the anabolic rate of visceral proteins decreases and the catabolic rate increases. An increase in capillary permeability in the inflammatory reaction leads to plasma visceral proteins extravasating into the interstitial space. In addition, hemodilution caused by fluid resuscitation is also the reason for the decrease of plasma visceral proteins level in critical illness. Therefore, an inconsistent relationship was found between visceral protein plasma levels and nutritional status in the acute phase of critically ill patients, and it also can not accurately reflect the effect of nutritional support. However, in stable critical patients without obvious inflammation, the plasma visceral protein levels can be used to dynamically evaluate the changes in the nutritional status. The decrease in plasma protein levels is associated with nutritional risk and poor prognosis in critical patients. This paper reviewes the metabolic characteristics of plasma visceral proteins in critically ill patients and the significance and limitations of plasma visceral proteins in nutritional assessment of critically ill patients.

Key words: Plasma visceral proteins, Malnutrition, Albumin, Prealbumin

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