ALB and nutritional deficiency disease: Mechanical ventilation often makes it difficult to obtain a dietary history, swelling and edema may hinder the accurate evaluation of muscle wasting, and the acute-phase response after inflammation or trauma may affect visceral protein (albumin and pre-albumin) concentrations.[[7], [8], [9]] As most patients are healthy individuals prior to trauma, nutritional biomarkers may serve as better indicators of malnutrition in these patients than in those with other critical illnesses (as they may have more comorbidities).