Patient Presentation. Transcript: Thinking points Decreased albumin production Increased a-1-AGP Possible p-450 reduction Increased liver/renal flow 49 yo female admitted with 86% TBSA burn (80% 3rd degree). > 5 month ICU stay. Multiple infections and antibiotic courses PMH Hypothyroidism Adrenal insufficiency SH 1/2 pack/d smoker FH Negative ....