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Albumin

Classification

Blood product, Colloid

Indications

CCP: Intravascular depletion

CCP: Burn patients overtreated with crystalloids in which hemodynamic goals are not being met

CCP: Hypoalbuminemia

Contraindications

Hypersensitivity
Severe anemia
Heart failure
Renal failure
Dilution with sterile water (may cause hemolysis)
TBI

Caution

Coagulation abnormality
Electrolyte imbalance
Hypervolemia/hemodilution
Hepatic impairment
Patients with increased microvascular permeability (eg, sepsis, trauma, burn)
Patients with sodium restrictions

Adult dosages

Use 5% solution in hypovolemic patients or intravascularly depleted patients. Use 25% solution in patients in whom fluid and sodium intake is restricted or to mobilize fluids.

CCP: Hypovolemia

12.5-25g IV 5%

CCP: Burns

25g IV 5% given at a rate of 1/3^rd fluid rate.

Pediatric Considerations And Dosing

CCP: Hypovolemia

1g/kg/dose 5% IV over 5-10 minutes

CCP: Hypoalbuminemia with ascites

0.5-1g/kg/dose 25% IV over 2-3 hours

Mechanism Of Action

Albumin is a replacement plasma protein. Due to its size, it increases intravascular oncotic pressure and causes the mobilization of fluids from the interstitial space to the intravascular space.

Pharmacokinetics

Half-life: 15-20 days

Adverse Effects

Cardiovascular:

Cardiac failure (precipitation), edema, hypertension, hypotension, tachycardia, coagulation abnormality

Central nervous system:

Chills, headache

Dermatologic:

Pruritus, skin rash, urticaria

Endocrine & metabolic:

Hypervolemia, electrolyte imbalance

Gastrointestinal:

Nausea, vomiting

Hypersensitivity:

Anaphylaxis

Respiratory:

Bronchospasm, pulmonary edema

Miscellaneous:

Fever

Warning And Precautions

Human plasma: Product of human plasma; may potentially contain infectious agents which could transmit disease. Screening of donors, as well as testing and/or inactivation or removal of certain viruses, reduces the risk.
In neonates, use the 25% concentration with extreme caution due to risk of intraventricular hemorrhage.
Use for other indications may be considered in pregnant women when contraindications to nonprotein colloids exist.
Available data are insufficient to recommend use of albumin to reduce the risk of ovarian hyperstimulation syndrome.
Endogenous albumin is present in breast milk.

Drug Interactions

No known specific interactions