The incidence of diarrhea in patients with hypoalbuminemia due to acute or chronic malnutrition during enteral feeding.

Abstract

Critically ill patients usually have hypoalbuminemia. The incidence of diarrhea in patients with hypoalbuminemia receiving enteral nutrition was studied. One hundred and ninety-eight patients with serum albumin level below 3 g/dl in the Burn Unit and Nutritional Support Service were retrospectively studied. Diarrhea was defined as liquid or loose stool at least three times a day with a daily volume of more than 300 g for at least 2 days. Most patients in the Burn Unit had acute or subacute onset of hypoalbuminemia, and most patients who were referred to the Nutritional Support Service had a chronic onset of hypoalbuminemia. The patients whose diarrhea were due to formula-related factors, administration techniques, or concomitant drug therapy were excluded. The results showed that 27% of the patients with albumin levels less than 2 g/dl had diarrhea, but only 10.5% of patients with albumin levels higher than 2 g/dl had diarrhea; the difference was significant. Diarrhea occurred in 35.1% of the patients with chronic development of hypoalbuminemia, but only 9.9% of the patients with rapid development of hypoalbuminemia had diarrhea; that difference also was significant. We concluded that the hypoalbuminemia-related diarrhea during tube feeding was significantly higher in patients with albumin levels less than 2 g/dl, and the patients with hypoalbuminemia due to chronic malnutrition had a significantly higher incidence of diarrhea than those with acute malnutrition, such as burned patients.