Clinical Indications: Albumin (Human Albumin), may be given intravenously without dilution or it may be diluted with normal saline or 5% glucose before administration. The addition of one volume of albumin solution to four volumes of normal saline or 5% glucose gives a solution approximately isotonic and iso-osmotic with citrated plasma. When undiluted albumin solution is administered in patients with normal blood volume, the rate of infusion should be slow enough (1 mL per minute) to prevent too rapid expansion of plasma volume.
Hypovolemic shock: Albumin is indicated in the treatment of hypovolemic shock associated with blood loss, trauma and surgical procedures. Albumin solutions are an accepted form of resuscitation, although crystalloids are the initial fluid of choice.
Burns: Albumin is used for severe burns (>15% body surface area) after the first 24 hours, if hypoproteinaemia develops and/or to maintain plasma volume.
Hypoproteinemia: Albumin is indicated in the treatment of hypo-proteinaemia caused by a loss of plasma proteins. Loss of plasma proteins may occur through decreased absorption in gastrointestinal disorders, inadequate synthesis in chronic liver diseases or excessive urinary catabolism in chronic liver diseases. This loss of proteins leads to oedema, secondary to a fluid shift from the intravascular space to the interstitium and a compensatory increase in salt and water retention. Albumin serves to restore colloid osmotic pressure and in, conjunction with a diuretic, promotes diuresis.
Ascites: Albumin may be used to maintain cardiovascular function following removal of large volumes of ascitic fluid in patients suffering from ascites.
Plasma exchange/dialysis: Albumin 20% may be used as an adjunct in patients who are undergoing long-term haemodialysis and are susceptible to shock and hypotension, or in dialysis patients who are hypovolaemic and may not tolerate large volumes of crystalloid infusion as treatment for shock or hypotension.
Indications: Albumin is the major protein involved in maintaining colloid osmotic pressure in the blood. It also binds a number of endogenous and exogenous substances including bilirubin, steroid hormones, and many, mainly acidic, drugs.
Albumin solutions are used for plasma volume replacement and to restore colloid osmotic pressure. They have been used in conditions such as burns, severe acute albumin loss, and acute hypovolemic shock. They are also used as an exchange fluid in therapeutic plasmapheresis. Concentrated albumin solutions are used in neonatal hyperbilirubinaemia.