Albumin and Related Products
Albumin as compared with nonprotein colloid or crystalloid solutions has not been well addressed in appropriately designed studies. Thus, albumin administration is based on an individual patient's clinical status. Clinical situations where albumin is commonly administered include replacement fluid for therapeutic plasma exchange, ovarian hyperstimulation syndrome, cirrhosis with spontaneous bacterial peritonitis, large-volume paracentesis, nephrotic syndrome, and fluid resuscitation in critically ill patients (e.g., sepsis, acute burns). Alternatives to albumin for plasma expansion include crystalloids (e.g., 0.9% sodium chloride [normal saline], Ringer lactate), alternate protein colloids (e.g., plasma protein fraction), and nonprotein colloids (e.g., dextran, gelatin, and starches). Crystalloids and nonprotein colloids have not demonstrated a benefit over albumin but are less expensive. In addition, nonprotein colloids have been associated with adverse effects.
