Increase in Serum Albumin After 100 mL of 25% Albumin Administration
One injection of 100 mL of 25% albumin solution typically increases serum albumin levels by approximately 0.2-0.3 g/dL in most patients. 1
Albumin Pharmacokinetics and Administration
- 25% albumin solution contains 25 g of albumin per 100 mL (25 g/dL), providing a concentrated source of albumin for intravascular volume expansion 1
- When administered intravenously, albumin undergoes distribution throughout the intravascular space, with approximately 40-60% remaining in the circulation initially 1
- The increase in serum albumin is affected by the patient's body weight, existing albumin levels, and the rate of albumin degradation 1
Factors Affecting Albumin Response
- Albumin infusions significantly increase albumin degradation rates - a study showed that 58% of infused albumin was accounted for by increased degradation 1
- A 15% increase in serum albumin concentration led to a 39% increase in albumin degradation in clinical studies 1
- Patients with severe hypoalbuminemia may show a more pronounced response to albumin administration compared to those with mild hypoalbuminemia 2
- Distribution volume varies based on the patient's clinical condition, with critically ill patients often having larger distribution volumes 3
Clinical Applications and Considerations
- In cirrhotic patients undergoing large volume paracentesis, albumin is recommended at a dose of 8 g per liter of ascites removed (typically as 20% or 25% solution) 1
- For spontaneous bacterial peritonitis, higher doses are recommended: 1.5 g/kg within 6 hours of diagnosis followed by 1 g/kg on day 3 1
- In critically ill hypoalbuminemic patients, albumin supplementation may improve organ function and result in less positive fluid balance 2
Practical Dosing Considerations
- For a 70 kg patient with hypoalbuminemia, 100 mL of 25% albumin (25 g) would be expected to increase serum albumin by approximately 0.2-0.3 g/dL 1
- The effect is transient due to redistribution and increased degradation, with the peak effect occurring shortly after infusion 1
- Multiple or larger doses may be required to achieve sustained increases in serum albumin levels 3
Potential Pitfalls
- Albumin administration alone may not address the underlying cause of hypoalbuminemia 4
- The cost-benefit ratio of albumin administration should be considered, as it is significantly more expensive than other volume expanders 5
- Potential adverse effects include allergic reactions, volume overload, and rarely, coagulation abnormalities 3
- The increase in serum albumin levels may not directly correlate with clinical improvement in all patients 4