Albumin Infusion

Albumin is basically a plasma protein, that is concerned with maintaining blood volume. Infusion of albumin may be required in certain medical conditions, like hypovolemia, and hypoalbuminemia.
HealthHearty Staff
Last Updated: Apr 8, 2018
Albumin is a type of protein found in blood plasma. In fact, it is the most abundant protein in blood plasma. Human serum albumin accounts for almost 60% of plasma protein. It is mainly produced in the liver. The normal range of human serum albumin level for adults is 3.4 to 5.4 g/dL, while for children less than three years, this range is 2.9 to 5.5 g/dL.

When the level of serum albumin is abnormally low, it is termed as hypoalbuminemia, which can be an indicator of certain diseases, including liver disease and nephrotic syndrome. Hypoalbuminemia can also be caused by severe burns. On the other hand, hyperalbuminemia refers to a high level of albumin. Albumin infusion refers to intravenous administration of albumin to treat certain medical conditions.

Functions of Serum Albumin

The main function of serum albumin is to maintain blood volume. Serum albumin maintains the oncotic pressure, which can be termed as a type of osmotic pressure, exerted by the plasma proteins on the capillary wall. It is also known by the name of 'colloid osmotic pressure', and it helps to pull water into the capillaries. When the level of albumin decreases to a large extent, the oncotic pressure reduces, which in turn, results in greater fluid leakage from the capillaries. This can eventually cause accumulation of fluid or water in the tissues, which is known as edema. Apart from maintaining blood volume, serum albumin acts as a carrier for certain molecules, that have low water solubility. Such molecules include, bile salts, bilirubin, free fatty acids, lipid soluble hormones, calcium ions, and certain drugs.

Preparation of Albumin Solution

Albumin solution is prepared from human plasma by alcoholic precipitation. Human plasma can contain various pathogens, for which albumin solution is usually pasteurized for several hours. The risk for the transmission of infectious agents is further reduced by screening the plasma donors, for the presence of certain infections and infectious agents. For therapeutic uses, human albumin solution can be usually found at the concentration of 5 to 25%.

Conditions that may Require Albumin Infusion

Hypovolemia or Hypovolemic Shock

This condition is characterized by a significant decrease in the volume of circulating blood or blood plasma. As we already know, albumin helps maintain volume of blood, by maintaining oncotic pressure and pulling interstitial fluid into the circulatory system. Therefore, intravenous administration of albumin may be required for treating this condition. However, the effectiveness of albumin in reversing hypovolemia depends on the availability of interstitial fluid and hence, it is more effective in individuals who are well-hydrated.

Hypoalbuminemia

Hypoalbuminemia is another condition, which may necessitate the infusion of serum albumin. Hypoalbuminemia can be caused by an inadequate production of albumin, which can be associated with malnutrition, burns, and severe infections. It can also be caused by hemorrhage, pancreatitis, and liver failure or liver cirrhosis. Administration of albumin in such a case can temporarily control the accompanied symptoms, until the underlying condition is diagnosed and treated.

However, in many cases, supplements of amino acids, along with the treatment of the underlying condition, may prove more effective in restoring the level of serum albumin than the infusion of albumin solution. But, if hypoalbuminemia is caused by severe infections, injuries, and pancreatitis, then nutritional supplements may not be effective in restoring the level of serum albumin quickly. Such a situation may necessitate the intravenous use of serum albumin.

Nephrosis

Nephrosis or nephrotic syndrome is the condition, where large amounts of protein or albumin get excreted from the body through urine. This condition is also characterized by edema or fluid retention, high cholesterol levels, and hypoalbuminemia. It can be caused by different disorders that damage the kidneys. Intravenous albumin may be required in acute severe nephrosis, in order to treat edema.

Adult Respiratory Distress Syndrome (ARDS)

Adult respiratory distress syndrome is the condition, where fluid builds up in the alveoli of the lungs. Severe shortness of breath is the main symptom of this condition. Adult respiratory distress syndrome mainly develops in patients suffering from a critical illness or severe infection. A lot of uncertainties exist, regarding the effectiveness of serum albumin in treating adult respiratory distress syndrome. Intravenous administration of albumin might prove helpful, if adult respiratory distress syndrome is accompanied by hypoalbuminemia and pulmonary overload.

Cardiopulmonary Bypass Surgery

Infusion of serum albumin is sometimes carried out prior to, or during cardiopulmonary bypass surgery. This is basically done to maintain blood volume during the surgery. However, blood volume can also be maintained by administering crystalloid solutions.

Hemolytic Disease of the Newborn

Hemolytic disease of the newborn is primarily caused by the incompatibility of the Rh blood groups, between the mother and the child/fetus. During pregnancy, some antibodies from mother's body cross the placenta and enter the circulatory system of the fetus. These maternal antibodies can sometimes, attack the red blood cells of the newborn and cause hemolytic disease. This attack normally begins during pregnancy, i.e., when the baby is still in the womb. Albumin infusion may be required at times, to treat severe hemolytic disease in newborns, mainly to bind and detoxify the unconjugated bilirubin.

Apart from these, intravenous administration of albumin solution might prove helpful in conditions like, acute liver failure, and ascites. Sometimes, it may also be required for maintaining the level of systolic blood pressure, and during hepatic surgery or transplantation.

Before Using Albumin

If you have any of the following conditions, then talk to your health care provider before using albumin.

If you are pregnant or breastfeeding, or planning to become pregnant.

If you have heart disease, kidney disease, and chronic anemia.

If you are taking any medication (prescription or non-prescription), supplements, and herbal preparation.

If you are allergic to certain specific drugs, foods, or other substances.

If the patient is dehydrated, then albumin infusion should be accompanied, or followed, by the administration of adequate fluid. Moreover, one needs to be very particular regarding the infusion rate. The infusion rate should never be more than the rate, specified by the physician. Albumin should be administered under the supervision of a medical practitioner, and during this period, the patient needs to be closely monitored. This is because, some people may develop allergic reactions, which can manifest in rash, fever and chills, difficulty in breathing, tightness in the chest, swelling of the mouth, face, lips, and tongue, and changes in pulse and blood pressure.

Disclaimer: This article is for informative purposes only, and should not be treated as a substitute for professional medical advice.