Indications for I'V ALBUMIN In Evidence Based Medicine

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Indications for I.V ALBUMINIn Evidence Based
Medicine

D-NeurosurgeryTo combat vasospasm in
aneurysmal subarachniod hemorrhage.E-Cardiothora
cic surgeryFor priming in open heart
operations. F-Nephrology1-During
dialysis in hypotensive patients.2- In nephrotic
with acute severe peripheral or pulmonary edema
who have failed diuretic therapy.3- In plasma
exchange in conjunction with large volume plasma
exchange greater than 20 ml/kg in one session, or
greater than 20 ml/kg/week in repeated sessions)
is appropriate.4-In transplantation if the
following conditions are metSerum albumin less
than 2.5 g/dlPulmonary capillary wedge pressure
less than 12 mm hg.Hematocrit greater than 30

References 1. Human albumin administration in
critically ill patients systematic review of
randomized controlled trials. Cochrane Injuries
Group Albumin Reviewers. BMJ 1998 317
235-240. 2. Schierhout G, Roberts I. Fluid
resuscitation with colloids or crystalloids in
critically ill patients A systematic review of
randomized trials. BMJ 1998 316 961-64. 3.
Joachim Boldt. The Good, the Bad, and the Ugly
Should we completely banish human albumin from
our intensive care units? Anesth Analg 2000 91
887-95. 4. Alexander MR, et al. Albumin
utilization in a university hospital. Ann
Pharmacother 198923214-17 5. Yeun JY, et al.
C-reactive protein predicts all - cause and
cardiovascular mortality in haemodialysis
patients. Am J Kidney Dis 2001 35 469-76. 6.
DeGaudio AR. Therapeutic use of albumin. Int J
Artif Organs 1995 18216-24. 7. Weaver DW,
Ledgerwood AM, Lucas CE et al. Pulmonary effects
of albumin resuscitation for severe hypovolemic
shock. Arch Surg 1978 113 387-92.
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For ResuscitationThere is no evidence
that resuscitation with colloids reduces the
risk of death, compared to resuscitation with
crystalloids, in patients with trauma, burn or
following surgery.
A- Ascites 1- In large volume paracentesis(gt5
liters ) iv albumin is given at a dose of 8 g
albumin/liters of ascites removed.2- In
patients with cirrhosis and spontaneous bacterial
peritonitis, plasma volume expansion with albumin
reduced the development of renal impairment and
death. The albumin dose was 1.5 g/kg of body
weight for the first 6 hour and one gm/kg on day 3
B-Surgery1Pre-operative and post operative
management of a patient with GI anastomosis if
serum albumin is below 3 gm/dl2 In cirrhotic
patients if they are going to have major surgery
and their serum albumin is below 3
gm/dlC-Pediatrics1- Nephrotic syndrome with
clinical hypovolemia.2-Neonatal
hyperbilirubinemia before exchange transfusion if
serum bilirubin isgt20 mg/dl and serum albumin is
less than 3gm/dl.
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