treatment of hypovolemic shock, burn therapy, cardiopulmonary bypass
with or without edema, adult respiratory distress syndrome (ARDS)
liver failure, neonatal hemolytic disease
resuspension, sequestration of protein rich foods
against signs of circulatory overload.
Albumin 25% is hyperoncotic,
therefore, in the presence of dehydration, albumin must be followed by
addition of fluids.
presence of hemorrhage, albumin should be supplemented by the
transfusion of whole blood to treat the relative anemia associated
with hemodilution. When circulating blood volume has been reduced,
hemodilution following the administration of albumin persists for many
hours. In patients with
normal blood volume, hemodilution lasts for a much shorter time.
rapid rise in blood pressure may follow the administration of a
colloid with positive oncotic activity necessitates careful
observation to detect and treat severed blood vessels which may not
have bled at the lower blood pressure.
Reactions (Side Effects):
Such reactions may be allergic in nature or due to high plasma protein
levels from excessive albumin administration.
Allergic manifestations include urticaria, chills, fever, and
changes in pulse, respiration and blood pressure.
administered by intravenous infusion; albumin 25% may be administered
undiluted or diluted in 0.9% Sodium Chloride or 5% Dextrose in Water.
The volume administered and the speed of infusion should be adapted
to the response of the patient
After a burn injury (usually 24 hours) there is a close correlation
between the amount of albumin infused and the resultant increase in
plasma colloid osmotic pressure.
The aim should be to maintain the plasma albumin concentration
in the region of 2.5 , plus or minus 0.5g, per 100ml with a plasma
oncotic pressure of 22 mm Hg. This is best achieved by IV administration of albumin 25%.
The duration of therapy is decided by the loss of protein from
the burned areas and in the urine,
In addition, oral or parenteral feeding with amino acids should
be initiated, as the long-term administration of albumin should not be
considered as a source of nutrition.
with or without edema:
Unless the underlying pathology for hypoproteinemia can be corrected,
the IV administration of albumin 25% must be considered purely
symptomatic or supportive. The
usual daily dose of albumin for adults is 50 to 75g and for children
25g. Patients with severe
hypoproteinemia who continue to lose albumin may require larger
hypoproteinemic patients usually have normal blood volumes, the rate
of administration should not exceed 2 ml/min as more rapid injection
may precipitate circulatory embarrassment and pulmonary edema.