WHO Model Prescribing Information: Drugs Used in Anaesthesia
(1989; 60 pages) [French] View the PDF document
Table of Contents
View the documentPreface
View the documentIntroduction
Open this folder and view contentsPremedication
Open this folder and view contentsGeneral anaesthetics and oxygen
Open this folder and view contentsLocal anaesthetics
Open this folder and view contentsNon-opioid analgesics
Open this folder and view contentsOpioid analgesics and antagonists
Open this folder and view contentsMuscle relaxants and cholinesterase inhibitors
Close this folderBlood substitutes
View the documentAlbumin, human
View the documentDextran 70
Open this folder and view contentsSolutions for correcting water and electrolyte imbalance
Open this folder and view contentsAntacid for use in obstetric practice
View the documentAnaesthesia at the District Hospital
View the documentSelected WHO publications of related interest
View the documentBack cover
 

Albumin, human

Group: plasma-volume expander
Injectable solution: 250 mg (dried albumin)/ml (25%)

General information

Concentrated human albumin solution is prepared from pooled blood, plasma, serum or placental tissue derived from healthy human donors. It is subsequently heat-treated to inactivate bacterial and viral organisms. All supplies should comply with the WHO Requirements for the Collection, Processing and Quality Control of Blood, Blood Components and Plasma Derivatives1 to prevent any risk of transmitting hepatitis or acquired immunodeficiency syndrome.

1 WHO Technical Report Series (WHO Expert Committee on Biological Standardization: thirty-ninth report). Annex 4 (in press).

Because it contributes to the colloid oncotic pressure of plasma, human albumin is an important determinant of plasma volume.

It has an inherent advantage over synthetic plasma expanders but its expense precludes its routine use.

Clinical information

Uses

Human albumin should be reserved for maintaining plasma volume in conditions where there is loss of plasma protein over periods of several days or weeks, as in ulcerative colitis, peritonitis or acute bowel obstruction.

It can also be used as an immediate short-term measure in severe haemorrhage pending the availability of blood.

Dosage and administration

Pre- and perioperative management of colloid deficit

Adults: 25-100 ml of albumin solution may be required daily for several days before and after surgery.

Acute blood loss

Adults: 500-1000 ml of albumin solution infused intravenously over 15 minutes may compensate for moderate blood loss. However, albumin has no oxygen-carrying capacity and fresh blood should be transfused when losses exceed 15% of the normal blood volume.

Precautions

The erythrocyte volume fraction should be monitored and maintained by transfusions of fresh blood, if necessary, throughout the period of treatment.

Clinically dehydrated patients always require fluids and electrolytes in addition to albumin infusions.

The infusion must be stopped immediately if signs of pulmonary oedema develop.

Adverse effects

Adverse reactions are infrequent. Fever, nausea, urticaria and hypotension rarely occur.

Storage

Stored below 25°C the solution will last 3 years. Stored between 2°C and 5°C it will last for 5 years. Solutions that have been allowed to freeze should not be used if they are turbid or contain sediment.

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