(1989; 60 pages) [French]
Group: plasma-volume expander
Injectable solution: 250 mg (dried albumin)/ml (25%)
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.
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.
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 reactions are infrequent. Fever, nausea, urticaria and hypotension rarely occur.
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.