Albumin vs. non-protein colloids for fluid resuscitation: does it matter?

Abstract

Objective: Albumin is an effective plasma volume expander (PVE); however, the cost and frequent shortages of albumin have led hospitals to adopt guidelines for the use of alternative colloid PVE's.Many of these guidelines recommend the use of crystalloids as a first line of therapy as well as the substitution of albumin by less expensive non-protein colloids. These alternatives have demonstrated efficacy similar to that of albumin in many clinical indications. However, while the administration of crystalloids and finite amounts of non-protein colloids is usually safe, their safety has been questioned in some patient subgroups as well as when large doses are administered. The objective of this paper is to discuss albumin and alternative PVE's to highlight clinical situations where they are preferred. Data source: Published original research articles, review articles, textbooks, abstracts in both English and non-English have been reviewed. Study selection: Studies on the use of albumin and non-protein volum...