From the Guidelines
Recommended Albumin Dose After Paracentesis
The recommended dose of albumin to administer after paracentesis is 8 g albumin/L of ascites removed 1. This is typically given as a 20% or 25% albumin solution.
- For paracentesis of >5 L, albumin infusion is strongly recommended at a dose of 8 g albumin/L of ascites removed 1.
- For paracentesis of <5 L, albumin infusion can be considered at a dose of 8 g albumin/L of ascites removed in patients with ACLF or high risk of post-paracentesis acute kidney injury 1.
- The exact dose and duration may vary depending on the patient's individual needs and clinical circumstances, such as the presence of diuretic-resistant ascites or refractory ascites 1.
- In general, a dose range of 6-8 g of albumin per liter of drained ascites is recommended for therapeutic large-volume paracentesis 1.
- For example, if 4 liters of ascitic fluid are removed, 32 grams of albumin (128 mL of 25% albumin solution) can be administered.
From the Research
Recommended Dose of Albumin
The recommended dose of albumin to administer after paracentesis is:
- 6-8 g per 1 liter of removed ascites, as stated in the studies 2, 3, 4
- 25 g for each tap, as reported in the study 5
- Standardized doses of 25 g (5-6 L removed), 50 g (7-10 L), and 75 g (>10 L), as implemented in the study 6
Administration of Albumin
Albumin is typically administered intravenously after paracentesis to prevent paracentesis-induced circulatory dysfunction (PICD) and to expand plasma volume. The administration of albumin has been shown to be safe and effective in reducing complications and improving patient outcomes 3, 6, 5, 4.
Key Findings
Key findings from the studies include:
- The use of albumin after paracentesis reduces the risk of circulatory dysfunction and renal impairment 3, 6, 4
- The standardized use of albumin can reduce the amount of albumin given without increasing adverse effects 6
- Therapeutic paracentesis with albumin infusion is a safe and effective treatment for cirrhotic patients with tense ascites 2, 3, 5, 4