Indications for Human Albumin Administration

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.

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.