In acute and critically ill patients with gastrointestinal surgical diseases, especially in the case of longer duration of disease and surgery, there is a rapid and significant decrease in serum albumin concentration due to decreased albumin synthesis, increased catabolism (shortened half-life of 5.52-11.76 d compared with normal 20-22 d) and intra- and extravascular redistribution. The present study also confirmed that the serum albumin level of patients in the 1st postoperative day (25.12±3.67 g/L) was significantly lower than the normal range (35-50 g/L), and the authors concluded that the main reason was related to the depletion of the underlying lesion and the infiltration of intravascular serum albumin into the extravasation. Liu Chun’an, Department of General Surgery, Ji’an Central People’s Hospital, hypoproteinemia can lead to intestinal wall edema and impaired recovery of intestinal function, and even affect the healing of the anastomosis, develop anastomotic fistula or other complications, prolong hospitalization, and even endanger the patient’s life.Haynes [1] concluded that the administration of albumin, which reduces intestinal wall edema, can lead to improved therapeutic outcomes and can be used in a variety of different clinical situations to Vincent et al [2] meta-analysis concluded that providing adequate exogenous albumin to patients with severe hypoproteinemia until plasma albumin concentration exceeded 30 g/L improved the tolerance of enteral feeding and reduced diarrhea, thus promoting the absorption and utilization of gastrointestinal nutrients. This study showed that the serum albumin level of cured patients in the study group was significantly higher than that in the control group, and the recovery of bowel sounds and the time of anal venting were significantly shorter than those in the control group. Therefore, the authors concluded that the administration of exogenous human albumin could increase the plasma colloid osmotic pressure and cause the fluid extravasated into the tissues to be reabsorbed, thus reducing the edematous state of the intestinal canal wall and promoting the recovery of intestinal function. There are many methods to assess nutritional status, and serum albumin is a relatively important indicator of nutritional status, and hypoproteinemia is a potential independent poor prognostic factor. The metabolic cycle of albumin is long, with a half-life of about 20-22 d, while the half-lives of prealbumin and transferrin are shorter, 1.9 d and 8.8 d, respectively. Therefore, prealbumin and transferrin are considered to be sensitive indicators of improved nutritional status in the short postoperative period. This study showed that serum prealbumin and transferrin concentrations were significantly higher in the study and control groups at postoperative d 7 compared with postoperative d 1. There was no significant difference in serum prealbumin and transferrin concentrations in the study group at postoperative d 7 compared with the control group at postoperative d 7. The authors concluded that the nutritional status of the patients would improve significantly after surgery with the improvement of emergency status, improvement of their condition and reasonable nutritional supplementation (including feeding); due to the long metabolic cycle of albumin, the exogenous human albumin infusion could not synthesize their own tissues and improve their nutritional status in the short term. Spiess et al [3] found that the reavailability of exogenous human albumin for re-synthesis of its own proteins is rather low, but it promotes the breakdown of its own proteins. Li Xiangyang et al [4] demonstrated that the infusion of exogenous albumin significantly increased the serum albumin level of patients. The present study also showed that serum albumin levels were significantly higher in the study group compared to the control group at d 7 postoperatively. The authors concluded that the infusion of exogenous human albumin only increased the serum albumin levels of patients including exogenous human albumin itself and did not improve the nutritional status of patients. The effect of albumin on improving microcirculation is related to the level of intravascular serum albumin, and the amount of exogenous human albumin retained in the vasculature and the hemodynamic effects it produces vary widely depending on the disease. It has been suggested that in the state of sepsis, due to direct cellular injury or the influence of inflammatory mediators, capillary permeability is enhanced, intravascular albumin, inflammatory cells and large amounts of fluid enter the tissue interstitial space, capillary leak syndrome occurs, the distribution of albumin inside and outside the blood vessels is changed, and supplemental exogenous human albumin does not remain in the blood vessels as desired to maintain plasma osmolality, so its Alderson et al [5] showed that in critically ill patients with hypoalbuminemia, there is no evidence that the application of albumin reduces mortality in critically ill patients.The SAFE study [6] of the role of human albumin and saline in fluid resuscitation in critically ill patients resulted in a significant reduction in mortality between the human albumin group and the control group at the end of the 28th d observation period. There was no significant difference in mortality due to various causes between the human albumin and control groups at the end of the 28th day observation period. This study also showed that although the infusion of exogenous human albumin increased the serum albumin level and improved intestinal function, it did not reduce the mortality rate of the patients. The authors suggest that the deceased patients may have developed capillary leakage syndrome due to very severe disease, and the infused exogenous human albumin leaked outside the blood vessels and thus failed to perform its proper function. In conclusion, we believe that in acute and critically ill gastrointestinal surgery patients with severe hypoprotein, reasonable nutritional support and appropriate infusion of exogenous human albumin, although not improving mortality, can improve intestinal function and accelerate the recovery of patients by increasing their plasma colloid osmotic pressure.