What is the typical duration for albumin infusion?

Albumin Infusion Administration Time Guidelines

The recommended administration rate for albumin infusion is not to exceed 2 mL per minute in patients with hypoproteinemia to avoid circulatory complications and pulmonary edema. 1, 2

Administration Rates and Duration

Albumin should always be administered by intravenous infusion, with careful attention to the rate of administration:

• For patients with hypoproteinemia: Maximum rate of 2 mL/minute 1, 2
• For standard administration: Slow intravenous infusion is recommended 1
• For 25% albumin: Administer slowly, particularly in patients with pre-existing cardiomyopathy 1

Preparation and Administration Considerations

• Albumin may be administered either undiluted or diluted in 0.9% Sodium Chloride or 5% Dextrose in Water 2
• If sodium restriction is required, albumin should only be administered either undiluted or diluted in a sodium-free carbohydrate solution such as 5% Dextrose in Water 2
• Only 16 gauge needles or dispensing pins should be used with 20 mL vial sizes and larger 2
• The stopper should be penetrated perpendicular to the plane of the stopper within the ring 2

Indication-Specific Dosing and Duration

The duration of albumin infusion varies based on the clinical indication:

1. Spontaneous Bacterial Peritonitis:

   • 1.5 g/kg on day 1 and 1 g/kg on day 3 1
   • Duration: 2 days of administration with evaluation after 1-2 days 1

2. Large-Volume Paracentesis (>5L):

   • 6-8 g of albumin per liter of ascites extracted 1
   • Duration: Single infusion administered after paracentesis is completed 1

3. Hypoproteinemia:

   • Adults: 50-75 g daily
   • Children: 25 g daily 2
   • Duration: Continued until underlying condition improves, with monitoring for response 2

Safety Considerations and Monitoring

• More rapid injection may precipitate circulatory embarrassment and pulmonary edema, particularly in patients with hypoproteinemia 2
• Careful monitoring is essential in patients with heart failure or at risk of volume overload 1
• The duration of therapy for burn patients is determined by the loss of protein from burned areas and in urine 2
• Administration should be carefully evaluated after 1-2 days based on the patient's volume status 1

Common Pitfalls and Caveats

• Administering albumin too rapidly is a common error that can lead to pulmonary edema and circulatory complications 1, 2
• Albumin should not be used routinely for hypoalbuminemia without specific indications 1, 3
• Simple albumin infusion without addressing the underlying cause does not improve survival in acute surgical patients with hypoalbuminemia 4
• The inappropriate use of albumin represents a significant cost to the healthcare system (approximately $20,000 per patient annually) 1

By following these guidelines for albumin infusion rate and duration, clinicians can maximize therapeutic benefits while minimizing potential complications related to administration.