ALB and ischemia: The estimation of IMA with the aid of the albumin Cobalt binding approach is primarily based on the fact that human ordinary albumin contains the aspartic acid, alanine, histidine, and lysine (N-Asp-Ala-His-Lys) series of amino acids in its N-terminus vicinity, with an excessive capability to bind to metal ions such as Cobalt (Co), Nickel (Ni), etc. But at some point of ischemia or due to extended oxidative stress, this albumin gets modified due to changes in those binding domains, resulting in a decrease in the affinity to bind Cobalt [15].