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?

    <p>20 days</p> Signup and view all the answers

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

    <p>10%</p> Signup and view all the answers

    What is a potential pleiotropic effect of human albumin?

    <p>Increasing the oncotic pressure</p> Signup and view all the answers

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

    <p>It is safe and well tolerated</p> Signup and view all the answers

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

    <p>It is the only plasma expander that has been shown to exert a plasma volume expanding effect</p> Signup and view all the answers

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

    <p>To restore the physiological balance of the liquid exchange between the intravascular and extravascular space</p> Signup and view all the answers

    What is the common indicator of hypovolemic shock?

    <p>Systolic blood pressure of less than 100 mmHg, heart rate of greater than 100 bpm, a weak pulse, and marked sweating</p> Signup and view all the answers

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

    <p>By drawing water from the interstitium into the intravascular space</p> Signup and view all the answers

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

    <p>Edema occurs when the oncotic pressure gradient between the intravascular and extravascular spaces decreases</p> Signup and view all the answers

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

    <p>To improve hypoalbuminemia and avoid the management of ascites</p> Signup and view all the answers

    What is the definition of hemodynamically stable patients?

    <p>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</p> Signup and view all the answers

    What is the suggested hemodynamic target for albumin treatment?

    <p>Mean arterial pressure of about 85-90 mmHg</p> Signup and view all the answers

    What is the relationship between the shock index and mortality?

    <p>Mortality is associated with a high shock index</p> Signup and view all the answers

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

    <p>To prevent shock-related multiorgan failure</p> Signup and view all the answers

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

    <p>Albumin regulates the intravascular volume by drawing water from the interstitium into the intravascular space</p> Signup and view all the answers

    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.

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    Explore the benefits of using human albumin in clinical practice, particularly in septic shock treatment, despite controversies and debates.

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