human albumin: clinical use

Prescribing considerations

• Base use on demonstrated volume deficiency and haemodynamic assessment rather than serum albumin concentration alone.
• Concentrated albumin has a greater colloid-osmotic effect; ensure adequate hydration and guard against hypervolaemia.
• Record the product name and batch number for every administration.
• Consider sodium content and electrolyte differences between preparations.

Contraindications and cautions

• Hypersensitivity to albumin preparations or any product excipient.
• Use particular caution where hypervolaemia or haemodilution could be hazardous, including decompensated cardiac failure, pulmonary oedema, hypertension, severe anaemia, bleeding tendency, oesophageal varices or renal/post-renal anuria.

Monitoring

• Blood pressure, pulse and urine output.
• Haemodynamic response and signs of circulatory overload.
• Electrolytes, haemoglobin and haematocrit; assess coagulation and other blood constituents when substantial volume replacement is required.
• Hypersensitivity during infusion.

Clinical pharmacology

Albumin supports plasma oncotic pressure and transports endogenous and exogenous substances. Distribution may become abnormal when capillary permeability is increased, including in severe burns or septic shock, making plasma-volume response unpredictable in critical illness.

Formulation and product differences

• Selected dilute preparations are mildly hypooncotic relative to normal plasma, whereas the selected concentrated preparation is hyperoncotic.
• Concentrated preparations contain less electrolyte relative to dilute solutions and require attention to hydration and electrolyte balance.
• Sodium content, excipients, permitted diluents, storage and opened-container instructions differ by product.

Solution for infusion

Route: Intravenous

Strengths: 50 g/L, 200 g/L