Indications for Human Albumin Administration
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Questions and Answers

What is the recommended treatment for massive ascites removal, especially when associated with diuretics due to refractory ascites?

  • Human albumin (correct)
  • Electrolyte solutions
  • Glucose solutions
  • Plasma exchange
  • According to international guidelines, what are human albumin solutions recommended for?

  • Plasma volume expansion or when electrolyte or glucose solutions are ineffective (correct)
  • Treating blue scrotum syndrome only
  • Treating acute dehydration only
  • Treating all types of bleeding disorders
  • In which condition should human albumin therapy be initiated?

  • Chronic kidney disease
  • Spontaneous pneumothorax
  • Acute respiratory distress syndrome
  • Spontaneous bacterial peritonitis in albumin-deficient patients (correct)
  • What is the benefit of human albumin in patients undergoing surgery?

    <p>It restores peritoneal filtration clearances</p> Signup and view all the answers

    What is the recommended treatment for submassive hemoptysis in LC-1 patients and patients with bullae?

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

    In acute liver cirrhosis, what should be administered to patients receiving large volume paracentesis?

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

    What is the primary indication for human albumin administration according to the European Pharmacopoeia?

    <p>Plasma volume expansion or when electrolyte or glucose solutions are ineffective</p> Signup and view all the answers

    In which condition should plasma exchange be initiated with human albumin?

    <p>Guillain-Barre syndrome</p> Signup and view all the answers

    What is the recommended dose of albumin to prevent and treat pressure refractory hypotension in patients with acute-onset systolic heart failure and volume overload?

    <p>2 grams per day in the first 48 h</p> Signup and view all the answers

    In which patient group is the administration of human albumin 20% demonstrated to increase survival by 37%?

    <p>Critically ill patients with serum albumin level lower than 2.4 g/dL</p> Signup and view all the answers

    What is the primary indication of ICU admission for volume expansion in patients with liver disease associated with cerebral edema?

    <p>Serum albumin concentration level of &lt; 1.5 g/dL</p> Signup and view all the answers

    In which clinical scenario is albumin administration undesirable according to current guidelines and recommendations?

    <p>Hypovolemic patients with a neutrophil-to-lymphocyte ratio &gt; 5.8</p> Signup and view all the answers

    What is the primary goal of albumin administration in patients with large-volume ascites and dilutional hyponatremia?

    <p>To prevent hepato-renal syndrome</p> Signup and view all the answers

    Which guidelines advise albumin use in combination with Ceftriaxone or broad-spectrum antibiotics in SBP?

    <p>ASCITES and ISIC guidelines</p> Signup and view all the answers

    In which patient group is albumin replacement eligible according to disease-specific guidelines?

    <p>NICU infants with congenital hypoalbuminemia and nephrotic syndrome</p> Signup and view all the answers

    What is the recommended use of albumin in patients with burns and hypoalbuminemia?

    <p>Albumin use is recommended only in cases with circulatory failure</p> Signup and view all the answers

    What is the primary concern in patients with severe hypoalbuminemia and acute kidney injury undergoing hemodialysis?

    <p>Preventing intradialytic hypotension</p> Signup and view all the answers

    Which of the following is not a recommended use of albumin according to current guidelines and recommendations?

    <p>In patients with severe hypoalbuminemia in isolation</p> Signup and view all the answers

    Study Notes

    Indications for Human Albumin Administration

    • Human albumin is administered to treat acute dehydration due to burns, paracentesis, or surgery when associated with hypertonic solutions.
    • It is also used to expand plasma volume restoration in hypovolemic shock cases.
    • Blue scrotum syndrome is a less recognized but more frequent indication for human albumin administration.
    • Albumin-deficient patients with spontaneous bacterial peritonitis should receive albumin infusions as therapy.
    • Human albumin is recommended when massive ascites are removed, especially when associated with diuretics due to refractory ascites.
    • Plasma exchange should be initiated with human albumin in patients with Guillain-Barre syndrome.
    • Human albumin is administered in acute coma due to liver cirrhosis, especially after large volume paracentesis.
    • It restores peritoneal filtration clearances, which are reduced during surgery.

    Specific Clinical Scenarios

    • Submassive hemoptysis in LC-1 patients and patients with bullae may also warrant albumin administration.
    • Human albumin administration is justified in patients with severe hypoalbuminemia and Acute Kidney Injury (AKI) undergoing hemodialysis to prevent intradialytic hypotension.
    • Resuscitation with human albumin 20% has been demonstrated to increase survival by 37% in critically ill patients with a serum albumin level lower than 2.4 g/dL.
    • A serum albumin concentration level of < 1.5 g/dL may be a primary indication of ICU admission for volume expansion in patients with liver disease associated with cerebral edema.
    • Human albumin administration is indicated in patients with large-volume ascites and dilutional hyponatremia at risk of hepato-renal syndrome.

    Current Guidelines and Recommendations

    • Hypervolemic patients with a neutrophil-to-lymphocyte ratio > 5.8 should not be treated with intravenous albumin.
    • Two grams of albumin per day in the first 48 h as part of a multiprotein treatment is recommended to prevent and treat pressure refractory hypotension in patients with acute-onset systolic heart failure and volume overload.
    • Severe hypoalbuminemia in isolation does not justify albumin administration.
    • Albumin use is recommended for patients with hypovolemic shock, burns, and hypoalbuminemia, in all cases with circulatory failure.

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    Description

    Learn about the various indications for human albumin administration, including treating acute dehydration, expanding plasma volume, and managing albumin-deficient patients. Discover the different scenarios where human albumin is used as a therapeutic agent.

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