Practice and Research on Clinical Medication Safety
Should albumin be a conventional medication after gastrectomy?
Yongqi Qiao, Weihua Wang, Yuanyuan Dai, Yibin Xie
Published 2019-06-28
Cite as ADRJ, 2019, 21(3): 213-217. DOI: 10.3760/cma.j.issn.1008-5734.2019.03.010
Abstract
A 61-year-old male patient with gastric cancer received routine albumin supplementation after surgery, which resulted in hypoalbuminemia, increased abdominal drainage fluid and pleural effusion. Clinical pharmacists and surgeons did literature reviews and discussions, and finally reached consensuses on albumin administration of patients after gastric cancer surgery. The consensuses were as follows: (1) it is not recommended to conduct albumin supplementation routinely after gastric cancer surgery; (2) albumin is not an effective nitrogen source and it cost too much to be used as a source of postoperative nutrition or protein; (3) for patients with postoperative hypoproteinemia (<30 g/L), albumin supplementation should be used after the surgical stress response period (day 4 after the surgery) and discontinued when the serum albumin is >30 g/L; (4) for patients with peritoneal and/or pleural effusion after surgery, the nature of the effusion should be defined firstly, and albumin can be supplemented only when the transudate is determined.
Key words:
Gastrectomy; Postoperative period; Albumins; Hypoalbuminemia; Pharmacists; Pharmaceutical services
Contributor Information
Yongqi Qiao
Department of Pharmacy, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Weihua Wang
Department of Pharmacy, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Yuanyuan Dai
Department of Pharmacy, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Yibin Xie
Department of Pancreatic and gastric surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China