Analysis of the Effectiveness of 20% Human Albumin Therapy Compared to 25% Human Albumin in Postoperative Digestive Surgery Patients With a Diagnosis of Hypoalbumin in the Intensive Care Room
Abstract
Hypoalbuminemia is generally identified in patients undergoing preoperative care, the recovery phase after surgery, and those in the healing process. At DR. M. Djamil General Hospital, the therapy to improve albumin levels in patients receiving intensive postoperative care involves using 20% human albumin and 25% human albumin. This study aims to evaluate and compare the effectiveness of 20% and 25% human albumin in increasing albumin levels in postoperative hypoalbuminemia patients at the institution. Data collection for this research was conducted retrospectively with a cross-sectional approach, where data were analyzed to determine how the increase in albumin levels after the administration of 20% or 25% human albumin affected clinical outcomes in patients. Findings from the proportionality testing in the subject characteristics involved in the research showed no disparity in the proportion of patient characteristics between the group receiving 20% human albumin (n=27) and the group receiving 25% human albumin (n=33) (p>0.05). Furthermore, the comparative mean analysis indicated a statistically significant difference in the levels of hypoalbuminemia before and after albumin infusion therapy in each group (p<0.05). The average increase in hypoalbuminemia in the group using 20% human albumin was recorded at 0.46 g/dL, while in the group with 25% human albumin, the increase reached 0.66 g/dL. Statistical analysis of the mean difference showed a statistically significant average increase in albumin concentration among the studied groups, with a p-value of less than 0.05. In this context, 25% of human albumin contributed to a significantly higher average increase in albumin concentration. Given the significant cost difference between 20% and 25% human albumin, it is recommended to use 20% human albumin for patients with albumin levels above 2.1 g/dL. Meanwhile, for patients with albumin levels below 2.1 g/dL, it is more appropriate to use 25% human albumin.
References
[2] Bektiwibowo, S., Munasir, Z., & Nasar, S. S. “Pemberian Nutrisi Enteral kasus Bedah Anak: Pengaruh pada Status Nutrisi”. Sari Pediatri, vol. 7, no. 3, pp. 136-42, 2016.
[3] Berger, M. L., Bingefors, K., Hedblom, E. C., Pashos, C. L., & Torrance, G. W. “Health Care Cost, Quality, and Outcomes”. ISPOR Book of Terms. Lawrenceville NJ, 2003.
[4] Bootman, J., L. Principle of Pharmacoeconomics (3rd ed.). Harvey Whitney Books Company, 2005.
[5] BPOM. Albumin. https://www.pom.go.id/new/browse/search/key/all/albumin.,2005.
[6] Braamskamp, M., J., Dolman, K., M., Tabbers, M., M. “Clinical practice. Protein-losing enteropathy in children”. J. Pediatry, vol. 169, no. 10, pp. 1179-1185, 2010.
[7] Branden, C. dan Tooze, J. Introduction to Protein Structures (2nd ed.), 2000.
[8] Brock, F., Bettinelli, L. A., Dobner, T., Stobbe, J. C., Pomatti, G., & Telles, C. T. “Prevalence of hypoalbuminemia and nutritional issues in hospitalized elders”. Revista Latino-Americana de Enfermagem, 24, e2736, 2016.
[9] Campos, Munoz A, Jain NK, Gupta M. Albumin Colloid. In: StatPearls. Treasure Island (FL): StatPearls Publishing, 2021.
[10] Cook, A. K., & Cowgill, L. D. “Clinical and pathological features of protein-losing glomerular disease in the dog: a review of 137 cases (1985-1992)”. Journal of the American Animal Hospital Association, vol. 32, no. 4, pp. 313-322, 1996.
[11] Delgado-Rodríguez, M., Medina-Cuadros, M., Gómez-Ortega, A., Martínez-Gallego, G., Mariscal-Ortiz, M., Martinez-Gonzalez, M. A., & Sillero-Arenas, M. “Cholesterol and serum albumin levels as predictors of cross infection, death, and length of hospital stay”. Archives of surgery, vol. 137, no. 7, pp. 805-812, 2002.
[12] Dilokthornsakul P, Thomas D, Brown L, Chaiyakunapruk N. Interpreting Pharmacoeconomic Findings. In: Clinical Pharmacy Education, Practice and Research. 1st ed. United Stated of America: Elsevier. p. 277, 2018.
[13] Doweiko, J. P., & Nompleggi, D. J. “The role of albumin in human physiology and pathophysiology, Part III: Albumin and disease states”. JPEN. Journal of parenteral and enteral nutrition, vol. 15, no. 4, pp. 476-483, 1991.
[14] Drummond MF, M.J. Sculpher, G.W. Torrance, DJ O'Brien, and Stooddart. Methods for The Economic Evaluation of Health Care Programme 3rd Edition. UK: Oxford University, 2005.
[15] Dumic, I., Nordin, T., Jecmenica, M., Stojkovic Lalosevic, M., Milosavljevic, T., & Milovanovic, T. “Gastrointestinal tract disorders in older age”. Canadian Journal of Gastroenterology and Hepatology, 2019(1), 6757524, 2019.
[16] Eichenwald EC, ed. Cloherty and Stark's Manual of Neonatal Care. 8th ed. Philadelphia, PA: Lippincott Williams & Wilkins, 2017.
[17] Ekatalog lkpp. Human Albumin. https://e-katalog.lkpp.go.id/id/search-produk?authenticityToken=c254bdff146fc3b8a9aec45e3e9bc4787017c5f3&q=albumin&prid=&pid=>=<=&mid=&kbid=&order=&cat=. 2022
[18] Evans, T. W. “albumin as a drug—biological effects of albumin unrelated to oncotic pressure”. Alimentary pharmacology & therapeutics, vol. 16, pp. 6-11, 2002.
[19] Fitria N. Pedoman Pembuatan Review Sistematik di Bidang Ekonomi Kesehatan. Padang: Andalas University Press. 2020.
[20] Formularium Nasional Kementerian Kesehatan Republik Indonesia. Albumin Serum Normal (Human Albumin). 2021.
[21] Gatta A, Verardo A, Bolognesi M. Hypoalbuminemia. Intern Emerg Med. Vol. 7, no. 3, pp. 193-199, 2012.
[22] Gounden V, Vashisht R, Jialal I. Hypoalbuminemia. Treasure Island (FL): StatPearls Publishing. 20 May 2020. http://www.ncbi.nlm.nih.gov/books/. 2020.
[23] Hasan, Irsan, Anggraini T. Peran Albumin dalam Penatalaksanaan Sirois Hati. Divisi Hepatologi, Departemen Ilmu Penyakit Dalam FKUI/RSCM. Jakarta. 2008.
