Usual Adult Dose for Peritonitis

Albumin 5%:

Initial dose: 250 or 500 mL IV at a rate of 1 to 2 mL per minute in the absence of overt shock. The capacity of the administration set is the only limit in the exsanguinated patient. The rate of infusion and total volume administered are determined by the condition and response of the patient. The initial dose may be followed by additional albumin within 15 to 30 minutes if the response is inadequate.

Albumin 25%:

Initial dose: The patient may require 200 to 300 mL IV to reduce edema and to bring serum protein values to normal. Since such patients usually have approximately normal blood volume, doses of more than 100 mL of albumin 25% should not be given faster than 100 mL IV over 30 to 45 minutes to avoid circulatory overload. If slower administration is desired, 200 mL of albumin 25% may be mixed with 300 mL of 10% dextrose solution and administered by continuous drip at a rate of 100 mL an hour IV.

Usual Adult Dose for Shock

Albumin 5%:

Initial dose: 250 or 500 mL IV at a rate of 1 to 2 mL per minute in the absence of overt shock. The capacity of the administration set is the only limit in the exsanguinated patient. The rate of infusion and total volume administered are determined by the condition and response of the patient. The initial dose may be followed by additional albumin within 15 to 30 minutes if the response is inadequate.

Albumin 25%:

Initial dose: The patient may require 200 to 300 mL IV to reduce edema and to bring serum protein values to normal. Since such patients usually have approximately normal blood volume, doses of more than 100 mL of albumin 25% should not be given faster than 100 mL IV over 30 to 45 minutes to avoid circulatory overload. If slower administration is desired, 200 mL of albumin 25% may be mixed with 300 mL of 10% dextrose solution and administered by continuous drip at a rate of 100 mL an hour IV.

Usual Adult Dose for Pancreatitis

Albumin 5%:

Initial dose: 250 or 500 mL IV at a rate of 1 to 2 mL per minute in the absence of overt shock. The capacity of the administration set is the only limit in the exsanguinated patient. The rate of infusion and total volume administered are determined by the condition and response of the patient. The initial dose may be followed by additional albumin within 15 to 30 minutes if the response is inadequate.

Albumin 25%:

Initial dose: The patient may require 200 to 300 mL IV to reduce edema and to bring serum protein values to normal. Since such patients usually have approximately normal blood volume, doses of more than 100 mL of albumin 25% should not be given faster than 100 mL IV over 30 to 45 minutes to avoid circulatory overload. If slower administration is desired, 200 mL of albumin 25% may be mixed with 300 mL of 10% dextrose solution and administered by continuous drip at a rate of 100 mL an hour IV.

Usual Adult Dose for Burns - External

Albumin 5%:

Initial dose: 250 or 500 mL IV at a rate of 1 to 2 mL per minute in the absence of overt shock. The capacity of the administration set is the only limit in the exsanguinated patient. The rate of infusion and total volume administered are determined by the condition and response of the patient. The initial dose may be followed by additional albumin within 15 to 30 minutes if the response is inadequate.

Albumin 25%:

Initial dose: The patient may require 200 to 300 mL IV to reduce edema and to bring serum protein values to normal. Since such patients usually have approximately normal blood volume, doses of more than 100 mL of albumin 25% should not be given faster than 100 mL IV over 30 to 45 minutes to avoid circulatory overload. If slower administration is desired, 200 mL of albumin 25% may be mixed with 300 mL of 10% dextrose solution and administered by continuous drip at a rate of 100 mL an hour IV.

Usual Adult Dose for Hypoproteinemia

Albumin 5%:

Initial dose: 250 or 500 mL IV at a rate of 1 to 2 mL per minute in the absence of overt shock. The capacity of the administration set is the only limit in the exsanguinated patient. The rate of infusion and total volume administered are determined by the condition and response of the patient. The initial dose may be followed by additional albumin within 15 to 30 minutes if the response is inadequate.

Albumin 25%:

Initial dose: The patient may require 200 to 300 mL IV to reduce edema and to bring serum protein values to normal. Since such patients usually have approximately normal blood volume, doses of more than 100 mL of albumin 25% should not be given faster than 100 mL IV over 30 to 45 minutes to avoid circulatory overload. If slower administration is desired, 200 mL of albumin 25% may be mixed with 300 mL of 10% dextrose solution and administered by continuous drip at a rate of 100 mL an hour IV.

Usual Adult Dose for Postoperative Albumin Loss

Albumin 5%:

Initial dose: 250 or 500 mL IV at a rate of 1 to 2 mL per minute in the absence of overt shock. The capacity of the administration set is the only limit in the exsanguinated patient. The rate of infusion and total volume administered are determined by the condition and response of the patient. The initial dose may be followed by additional albumin within 15 to 30 minutes if the response is inadequate.

Albumin 25%:

Initial dose: The patient may require 200 to 300 mL IV to reduce edema and to bring serum protein values to normal. Since such patients usually have approximately normal blood volume, doses of more than 100 mL of albumin 25% should not be given faster than 100 mL IV over 30 to 45 minutes to avoid circulatory overload. If slower administration is desired, 200 mL of albumin 25% may be mixed with 300 mL of 10% dextrose solution and administered by continuous drip at a rate of 100 mL an hour IV.

Usual Pediatric Dose for Peritonitis

Albumin 5%:

Initial dose: 10 to 15 mL per pound (4.5 to 6.8 mL per kg) of body weight IV is usually adequate accompanied by close surveillance of the child.

Usual Pediatric Dose for Shock

Albumin 5%:

Initial dose: 10 to 15 mL per pound (4.5 to 6.8 mL per kg) of body weight IV is usually adequate accompanied by close surveillance of the child.

Usual Pediatric Dose for Pancreatitis

Albumin 5%:

Initial dose: 10 to 15 mL per pound (4.5 to 6.8 mL per kg) of body weight IV is usually adequate accompanied by close surveillance of the child.

Usual Pediatric Dose for Burns - External

Albumin 5%:

Initial dose: 10 to 15 mL per pound (4.5 to 6.8 mL per kg) of body weight IV is usually adequate accompanied by close surveillance of the child.

Usual Pediatric Dose for Hypoproteinemia

Albumin 5%:

Initial dose: 10 to 15 mL per pound (4.5 to 6.8 mL per kg) of body weight IV is usually adequate accompanied by close surveillance of the child.

Usual Pediatric Dose for Postoperative Albumin Loss

Albumin 5%:

Initial dose: 10 to 15 mL per pound (4.5 to 6.8 mL per kg) of body weight IV is usually adequate accompanied by close surveillance of the child.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

When undiluted albumin 25% solution is administered to patients with normal blood volume, the rate of infusion should be slow enough (1 mL per minute) to prevent too rapid expansion of plasma volume.

The amount of albumin and duration of therapy in the treatment of shock should be based on the responsiveness of the patient as indicated by blood pressure, degree of pulmonary congestion, and hematocrit. The initial dose may be followed by additional albumin within 15 to 30 minutes if the response is inadequate. If there is continued loss of protein, it may be desirable to give packed red blood cells.

In the treatment of burns, an optimal regimen using albumin, crystalloids, electrolytes, and water has not been established. Suggested therapy during the first 24 hours includes administration of large volumes of crystalloid solution to maintain an adequate plasma volume. Continuation of therapy beyond 24 hours usually requires more albumin and less crystalloid solution to prevent marked hemoconcentration and maintain electrolyte balance. Duration of treatment varies depending upon the extent of protein loss through renal excretion, denuded areas of skin, and decreased albumin synthesis. Attempts to raise the albumin level above 4 g/100 mL may only result in an increased rate of catabolism.

Precautions

When dosing albumin, the 5% solution should be used in hypovolemic patients or intravascularly-depleted patients and the 25% solution should be used in patients in whom fluid and sodium intake is restricted.

Additional fluids should accompany or follow the administration of albumin if the patient is dehydrated.

Administration of large quantities of albumin should be supplemented with or replaced by packed red blood cells to combat the relative anemia which would follow such use.

Albumin should be administered with caution to patients with low cardiac reserve or with no albumin deficiency because a rapid increase in plasma volume may cause circulatory compromise (e.g., hypertension, hypotension, or pulmonary edema). In cases of hypertension, a slower rate of administration is desired: 200 mL of albumin solution may be mixed with 300 mL of 10% dextrose solution and administered at a rate of 10 g of albumin (100 mL) per hour.

No clinical studies using albumin 25% have been conducted in pediatric patients. Safety and effectiveness in pediatric patients (less than 18 years old) have not been established. However, extensive experience suggests that children respond to albumin 25% in the same manner as adults.

Dialysis

Data not available

Other Comments

The manufacturer does not recommend diluting albumin 5% solution.

Albumin 25% may be given intravenously without dilution or it may be diluted with normal saline or 5% dextrose before administration (200 mL per liter gives a solution which is approximately isotonic and iso-osmotic with citrated plasma).

Albumin, unlike whole blood or plasma, is considered free of the danger of homologous serum hepatitis. Albumin may be given in conjunction with other parenteral fluids such as saline, dextrose, or sodium lactate. It is convenient to use since no cross-matching is required and the absence of cellular elements removes the danger of sensitization with repeated infusions.

Albumin human solution is compatible with whole blood or packed red blood cells as well as the usual electrolyte and carbohydrate solutions intended for intravenous use. Albumin should not be mixed with protein hydrolysates, amino acid mixtures, or solutions containing alcohol. It is ready for use as contained in the bottle and may be given without regard to the blood group of the patient.