Abstract
Albumin may, from a physiological point of view, be considered an ideal natural colloid. At the present time, however, the indications for its clinical use are being seriously questioned. Hypoalbuminaemia is a normal phenomenon in the critically ill patient. Therefore, serum albumin should be considered a non-specific marker of disease processes and reduced levels are mainly the result of pathological events not the cause of them. The clinical value of repeated serum albumin determinations may, consequently, be questioned. The effects of albumin administration on plasma volume expansion are not entirely predictable, especially in pathological states accompanied by leaky capillary membranes. Therefore, albumin is not an ideal plasma volume expander and its supplementation shows no benefit on many kinds of tissue oedema. Albumin supplementation for treatment of hypoalbuminaemia in critically ill patients will probably only exert transient effects on the serum level, but the supplementation may at the same time even include a risk of increased morbidity and mortality. There are at the present time no clear indications for albumin administration. It seems appropriate to review the use of human albumin in most clinical situations and especially in critically ill patients suffering from hypovolaemia, burns, and hypoalbuminaemia.
Published Version
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