Shock: Albumin is indicated in the emergency treatment of shock and in other similar conditions where the restoration of blood volume is urgent. If there has been considerable loss of red blood cells, transfusion with packed red blood cells is indicated. Burns: Albumin or Albumin in either normal saline or dextrose is indicated to prevent marked hemoconcentration and to maintain appropriate electrolyte balance. Hypoproteinemia with or without edema: Albumin is indicated in those clinical situations usually associated with a low concentration of plasma protein and a resulting decreased circulating blood volume. Although diuresis may occur soon after albumin administration has been instituted, best results are obtained if albumin is continued until the normal serum protein level is regained.
Human albumin is not a glycoprotein. It has the lowest molecular weight (66,241 Daltons) of all plasma proteins. Because of its three dimensional structure, solutions of albumin have a lower viscosity than solutions of other plasma proteins. This is important since work performed by the heart depends in part on the viscosity of blood. Human albumin accounts quantitatively for more than half of the total proteins in the circulation (by weight) and represents approximately 10% of the protein synthesized in the liver. Approximately 40% of albumin is contained in the circulation. The remainder is located in the extravascular space of tissues, principally muscle, skin, and intestine. Human albumin 25% has a hyperoncotic effect. A major function of albumin is its role in osmotic regulation. Albumin is responsible for 75% of normal oncotic pressure within the intravascular space. Other physiological functions include binding and transport of molecules (hormones, enzymes, drugs and toxins); free radical scavenging; hemostatic effects (platelet function inhibition and antithrombotic effects); and capillary membrane permeability.
Hypovolemia: Adults Initial dose of 25 g is suggested. Pediatric dosage should be adjusted based upon on age, weight and clinical conditions.
Hypoalbuminemia: 50-75 g
Prevention of Central Volume Depletion after Paracentesis due to Cirrhotic Ascites: 6-8 g for every 1000 mL of ascitic fluid removed
OHSS Adults: Adults 50-100 g over 4 hours and repeated at 4-12 hour intervals as necessary. 10-50 g: single infusion
ARDS: Adults 25 g over 30 minutes and repeated at 8 hours for 3 days if necessary.
Burns: The amount of albumin required to achieve adequate plasma volume and protein content should be determined by direct observation of vital signs or measurement of either plasma oncotic pressure or protein content
Hemodialysis: 100 ml
Cardiopulmonary Bypass: Required dose can be estimated from the difference between the desired and actual total serum protein concentration multiplied by the estimated plasma volume (approximately 40 mL per kg) times 2 (to account for extravascular deficit, which absorbs about half of the administered dose).
Human Albumin should not be mixed with other medicinal products including blood and blood components, but can be administered concomitantly with other parenterals such as whole blood, plasma, saline, glucose or sodium lactate when medically necessary. Human Human Human Albumin should not be mixed with protein hydrolysates or solutions containing alcohol since these combinations may cause protein precipitation.
Human albumin is contraindicated in patients with a history of hypersensitivity to albumin, excipients used in its formulation, or components of the container. Human albumin is also contraindicated in severely anemic patients and in patients with heart failure.
The most common adverse reactions include flushing, urticaria, fever, chills, nausea, vomiting, tachycardia and hypotension. These reactions normally disappear when the infusion rate is slowed or stopped. If a severe reaction such as shock or anaphylaxis occurs, the infusion should be stopped and appropriate treatment initiated.
No human or animal data are available to indicate the presence or absence of drug-associated risk. It is not known whether Human albumin can cause fetal harm when administered to a pregnant woman or can affect reproductive capacity. No human or animal data are available to indicate the presence of absence of drug-associated risk. It is not known whether Human albumin is excreted in milk.
Hypervolemia may occur if the dosage and rate of infusion are too high. At the first clinical sign of circulatory overload, e.g. headache, dyspnea, jugular venous congestion, increased blood pressure, raised central venous pressure, or pulmonary edema, the infusion should be stopped and hemodynamic parameters carefully monitored. Additionally, diuresis or cardiac output should be increased in accordance with the severity of the clinical situation.
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
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