الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
Albumin is the most abundant protein in blood plasma, constituting up to two-thirds of total plasma proteins. It contributes about 80% of the plasma colloid osmotic pressure and is responsible for the transport and binding of many molecules.
Hypoalbuminemia is ascribed to diminished synthesis (eg, malnutrition, malabsorption, or hepatic dysfunction), increased losses (eg, urinary losses with nephropathy or protein-losing enteropathy) Also, Inflammatory disorders can accelerate the catabolism of albumin while simultaneously decreasing its synthesis.
Hypoalbuminemia is a common finding in critical illnesses in adults and pediatrics, as hypoalbuminemia proved to be a strong predictor for clinical outcome in adults.
Because serum albumin is a simple, cheap and sensitive marker, it has been used as a predictor of final outcome in adults ICU.
Although hypoalbuminemia is a common finding in critically ill children, there is lack in data that evaluate its usefulness in predicting clinical outcome.
In current study we aimed to Study serum albumin level in critically ill children admitted to pediatric intensive care unit and its relation to final outcome.
A cross sectional study was conducted on 118 children diagnosed as critically ill according to WHO guidelines admitted to the pediatric intensive care unit whatever their initial diagnosis at admission.
According to serum albumin level we categorized studied cases in to two groups, hypoalbuminemia group in which serum albumin level less than 3.5 g /dl and non-hypoalbuminemia group in which serum albumin level ≥ 3.5 g /dl.
According to serum albumin level within first 24 hours of admission hypoalbuminemia was observed in 72 cases (61%) while 46 cases were non hypoalbuminemia (39%).
According to mean values of Serum albumin in g/dl during picu admission, Hypoalbuminemia was observed in 84 cases (71.2%) while 34 cases were non hypoalbuminemia (28.8%).
In this study hypoalbuminemia group at admission was associated with prolonged period of Picu admission and a statistically significant lower Glasgow coma scale in comparison to non hypoalbuminemia group.
In current study we found a significant difference between the two studied groups during PICU admission according to final outcome.
In our study according to laboratory investigations at admission and during PICU admission, platelets count, Na level and CRP level all were of statistically significant in hypoalbuminemia group in comparison to non hypoalbuminemia group.
In our study it was statistically significant that scoring systems PSOFA, PRISM3 and NPAR showed significant increase in deteriorated & died group in comparison to improved& discharged group.
Also, it was statistically significant that both PSOFA and NPAR scoring systems were of higher scores in hypoalbuminemia group in comparison to non hypoalbuminemia group at admission.
Summary
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In current study the used soring systems PSOFA, NPAR and PRISM3 showed significant higher scores in hypoalbuminemia group when compared to non hypoalbuminemia group during admission.
In our study according to ROC curve study of scoring systems of studied groups at admission. , both PSOFA score (cut off point ≥3, sensitivity 61.11%, specificity 60.87%) and NPAR score (cut off point ≥18.2, sensitivity 62.50 %, specificity 65.22 %) were statistically significant (p=0012 and 0.003 respectively).
In our study according to ROC curve study of scoring systems of studied groups during PICU admission , PSOFA sore (cut off point ≥3, sensitivity 60.71%, specificity 67.65%) , PRISM3 score (cut off point ≥15, sensitivity of 69.05%, specificity 61.76%) and NPAR score (cut off point ≥16.8 , sensitivity 70.24% , specificity 61.76%) were statistically significant (P=0.002,0.001 and 0.003 respectively).