Neonatal albumin infusions in paediatric intensive care

Neonates are frequently hypoalbuminaemic, and the management of this condition is controversial. In adult studies, hypoalbuminaemia was shown to be a strong independent predictor of poor outcome. However, there is lack of evidence that normoalbuminaemia reduces morbidity and mortality in neonates,1 2 albeit in very low birthweight babies, hypoalbuminaemia has been shown to be associated with increased mortality.3 There is also another theory based on the fact that since albumin contributes to antioxidant capacity of plasma, low levels of plasma albumin may lessen the total plasma antioxidant capacity, thereby predisposing hypoalbuminaemic neonates to diseases where reactive oxygen species play a role, such as in necrotising enterocolitis,3 4 respiratory distress, chronic lung …