Serum protein levels in critically Ill surgical patients

Serum protein levels were found to be markedly reduced in 44 critically ill surgical patients after they had been resuscitated in an intensive therapy unit (ITU). There was no difference in initial protein levels between those patients who survived and those who died, or between those patients who reacted to skin testing with recall antigens and those who showed no reaction. However, albumin and transferrin levels were lower in those patients who had major sepsis (p<0.02). Twenty-six of the patients remained in the ITU for more than five days. Repeat measurements made in these patients shortly before death or discharge from the ITU showed that prealbumin and transferrin levels were still not different in 17 survivors and 9 non-survivors. However, the mean albumin level was lower in the non-survivors (p<0.02), although nearly all of the survivors also continued to have low levels of albumin. There was no improvement in serum protein levels in 10 patients who, on skin testing, converted from being non-reactors to reactors.Although reduced serum protein levels were a common finding in critically ill patient, they were not clearly related to outcome or the response to recall skin antigens and this suggests that these tests may be altered by different mechanisms.