Clinical Pros of Human Albumin Administration

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Questions and Answers

What is the current consideration of albumin use in clinical practice?

Strongly recommended as the first line of treatment
Only used for patients with a history of allergic reactions
Not considered mandatory and its use is questioned (correct)
Mandatory for all septic shock patients

What is the recommended initial therapy for patients with septic shock according to the Surviving Sepsis Campaign guidelines?

Administration of 30 mL/kg of albumin solution
Prompt administration of vasoactive drugs only
Administration of 10 mL/kg of crystalloid solution followed by albumin
Rapid administration of 30 mL/kg of crystalloid solution (correct)

What is the effect of administering albumin on plasma volume?

It decreases the plasma volume
It has no effect on plasma volume
It initially increases and then decreases the plasma volume
It increases the plasma volume, with a decrease in the plasma volume expansion as a function of the dose administered (correct)

What is the approximate residual time of human albumin in circulation?

20 days (D) Signup and view all the answers

What is the daily turnover of human albumin in the body?

10% (A) Signup and view all the answers

What is a potential pleiotropic effect of human albumin?

Increasing the oncotic pressure (A) Signup and view all the answers

What is the benefit of using albumin in subarachnoid hemorrhage patients?

It is safe and well tolerated (C) Signup and view all the answers

What is an advantage of human albumin over other plasma expanders?

It is the only plasma expander that has been shown to exert a plasma volume expanding effect (B) Signup and view all the answers

What is the primary role of albumin in maintaining hemodynamic stability?

To restore the physiological balance of the liquid exchange between the intravascular and extravascular space (A) Signup and view all the answers

What is the common indicator of hypovolemic shock?

Systolic blood pressure of less than 100 mmHg, heart rate of greater than 100 bpm, a weak pulse, and marked sweating (C) Signup and view all the answers

What is the primary mechanism by which albumin enhances oncotic pressure?

By drawing water from the interstitium into the intravascular space (D) Signup and view all the answers

What is the consequence of a decrease in the serum albumin concentration?

Edema occurs when the oncotic pressure gradient between the intravascular and extravascular spaces decreases (D) Signup and view all the answers

What is the therapeutic effect of albumin substitution in cirrhosis patients?

To improve hypoalbuminemia and avoid the management of ascites (A) Signup and view all the answers

What is the definition of hemodynamically stable patients?

Patients with a SBP greater than 90 mmHg, heart rate of less than 100 bpm, urine output of greater than 30 mL/hr, clear mental status, and a warm extremity with palpable pulses (D) Signup and view all the answers

What is the suggested hemodynamic target for albumin treatment?

Mean arterial pressure of about 85-90 mmHg (B) Signup and view all the answers

What is the relationship between the shock index and mortality?

Mortality is associated with a high shock index (A) Signup and view all the answers

What is the primary benefit of albumin administration in patients with trauma?

To prevent shock-related multiorgan failure (A) Signup and view all the answers

What is the role of albumin in regulating the intravascular volume?

Albumin regulates the intravascular volume by drawing water from the interstitium into the intravascular space (A) Signup and view all the answers

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Study Notes

Human Albumin Administration in Clinical Practice

The use of albumin in clinical practice is not considered mandatory, and its use in septic shock has been called into question by various studies.
The Surviving Sepsis Campaign guidelines recommend reducing the use of albumin as the fluid of choice in case of non-availability of crystalloids.
Human albumin is often prescribed for the treatment of hypoalbuminemia and its potential clinical advantages.

Clinical Advantages of Human Albumin

It is the only plasma expander that has been shown to exert a plasma volume expanding effect, with a decrease in the plasma volume expansion as a function of the dose administered.
It possesses a long residual time in circulation (approximately 20 days) with a daily turnover of about 10%, mainly through catabolism in the liver.
Its easy handling and the availability of a presentation not requiring dilution are also reported.

Improved Hemodynamic Stability

Patients with albumin replacement show less shock index (ratio of pulse to SBP) and faster resolution of the hyperdynamic phase.
Hemodynamically stable patients are defined as having a SBP greater than 90 mmHg, heart rate of less than 100 bpm, urine output of greater than 30 mL/hr, clear mental status, and a warm extremity with palpable pulses.
A suggested hemodynamic target would be mean arterial pressure of about 85–90 mmHg.

Enhanced Oncotic Pressure

Albumin can efficiently enhance oncotic force and avoid or even reduce the incidence of edema after surgery, improve hypoalbuminemia in cirrhosis patients, and avoid the management of ascites.
The oncotic property of albumin, which is modulated by the colloid osmotic pressure that it generates, draws water from the interstitium into the intravascular space.
The contribution of a large protein like albumin to plasma oncotic pressure is obviously beneficial when a decrease in the serum albumin concentration is compensated by the administration of HSA.