Critical Care Therapy

Albumin, processed from human plasma, has been safely used for almost 50 years to treat critically ill patients by replacing lost fluid and maintaining adequate blood volume and pressure. Albumin has one of the longest safety records of any plasma derivative. A protein found in the body, albumin is responsible for maintenance of blood volume and transporting drugs and other molecules through the plasma. Albumin expands plasma volume and increases cardiac output. When given intravenously, albumin can draw water back into the blood (each gram of albumin draws 18 grams of water into the blood) and help restore normal hemodynamics. Albumin is used in cardiac surgery, heart valve repair and replacement, and to treat hemorrhagic shock

Crystalloid solutions may be used instead of albumin in critical care situations.  Following are some clinical considerations regarding use of these therapeutics:

• Resuscitation endpoints are reached more rapidly with albumin and blood pressure is better maintained because albumin has a longer intravascular half-life than crystalloids.¹
• Albumin is better tolerated than nonprotein or synthetic colloids which have the potential to impair coagulation and negatively affect platelet function. Albumin has the lowest rate of side effects; untoward reactions to human albumin are extremely rare (see Prescribing Information).
• Older patients, with pre-existing medical illness, patients who have undergone surgery for extensive pathology or patients whose shock is caused by a medical disorder, may do better with colloids, according to National Institutes of Health recommendation.²

Ongoing clinical trials are investigating albumin’s role beyond volume expansion including antioxidant properties and anti-inflammatory properties; and a potential role in treating sepsis and acute respiratory distress syndrome (ARDS).³

 

The information provided is not intended to be a substitute for professional medical advice.  A licensed healthcare professional should be consulted for diagnosis and treatment of any and all medical conditions.

 

^{1 Vox Sang 1998: 74 (Suppl. 2): 69-74 Crit Care 1992:8:235-53}

^{2 NIH Albumin Workshop Recommendations, 1977}

^{3 Evans TW. Albumin Therapy: More Than Just Fluid Replacement. Proceedings of the 21st International Symposium on International Care and Emergency Medicine, 2001 Mar. 20-23 Brussels, Belgium}