Indications

Hypovolemia: For restoration and maintenance of circulating blood volume where volume deficiency is demonstrated and colloid use is appropriate.
Hypoalbuminemia: Severe deficiency due to illness or bleeding; temporary effect if caused by protein loss until underlying disorder is corrected.
Prevention of central volume depletion after paracentesis due to cirrhotic ascites.
Ovarian Hyperstimulation Syndrome (OHSS): As a plasma expander in fluid management of severe OHSS.
Adult Respiratory Distress Syndrome (ARDS): In conjunction with diuretics to correct fluid overload.
Burns: After 24 hours post burn in severe albumin depletion to favor edema reabsorption.
Hemodialysis: In long‑term dialysis patients who are fluid‑overloaded and cannot tolerate large volumes of salt solution.
Cardiopulmonary bypass: As part of priming fluid.

Pharmacology Human albumin is a non‑glycoprotein with molecular weight ~66 kDa.

Accounts for >50% of plasma proteins; ~40% in circulation, remainder in extravascular space.
Responsible for ~75% of normal oncotic pressure.
Functions: osmotic regulation, binding/transport of hormones, enzymes, drugs, toxins; free radical scavenging; platelet inhibition and antithrombotic effects; regulation of capillary permeability.
25% solution is hyperoncotic.

Dosage & Administration

Hypovolemia: Adults 25 g initially; pediatric dose adjusted by age, weight, condition.
Hypoalbuminemia: 50–75 g.
Cirrhotic ascites: 6–8 g per 1000 ml ascitic fluid removed.
OHSS: Adults 50–100 g over 4 hours, repeat at 4–12 h intervals if needed; single infusion 10–50 g.
ARDS: Adults 25 g over 30 min, repeat every 8 h for 3 days if necessary.
Burns: Dose individualized based on plasma volume/protein content.
Hemodialysis: 100 ml.
Cardiopulmonary bypass: Dose estimated from serum protein deficit × plasma volume (~40 ml/kg ×2).

Interactions

Should not be mixed with other medicinal products including blood components.
Can be given with whole blood, plasma, saline, glucose, sodium lactate when necessary.
Do not mix with protein hydrolysates or alcohol‑containing solutions (risk of precipitation).

Contraindications

Side Effects Common: flushing, urticaria, fever, chills, nausea, vomiting, tachycardia, hypotension.

Usually resolve when infusion slowed or stopped.
Severe reactions (shock, anaphylaxis): stop infusion, initiate appropriate treatment.

Pregnancy & Lactation

Precautions & Warnings

Use in Special Populations

Children 12–16 years: adult dose may be given.
<12 years: not clinically evaluated; typically ¼–½ adult dose depending on weight and condition.
Physicians should weigh risks and benefits carefully.

Overdose Effects

Hypervolemia may occur if dose/rate too high.
Signs: headache, dyspnea, jugular venous congestion, increased blood pressure, raised central venous pressure, pulmonary edema.
Management: stop infusion, monitor hemodynamics, use diuretics or increase cardiac output as needed.