How to Administer Injection Albumin
Albumin should be administered intravenously, with the rate and dose tailored to the clinical indication, patient's condition, and risk of volume overload. 1
Administration Technique
- Albumin should always be administered by intravenous infusion, either undiluted or diluted in 0.9% Sodium Chloride or 5% Dextrose in Water 1
- 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 1
- Before administration, remove the seal to expose the stopper and swab with a suitable antiseptic 1
- Use 16 gauge needles or dispensing pins with 20 mL vial sizes and larger, inserting them perpendicular to the plane of the stopper within the designated ring area 1
- Visually inspect the solution for particulate matter and discoloration prior to administration 1
Dosing Guidelines Based on Indication
Congenital Nephrotic Syndrome
- Base albumin infusion on clinical indicators of hypovolaemia (prolonged capillary refill time, tachycardia, hypotension, oliguria, abdominal discomfort) rather than serum albumin levels 2
- For patients with severe disease, daily albumin infusions of 1–4 g/kg may be initiated 2
- Consider administering a dose of furosemide (0.5–2 mg/kg) at the end of each albumin infusion, unless the patient has marked hypovolaemia and/or hyponatraemia 2
Liver Disease/Cirrhosis
- For large volume paracentesis (>5L), administer albumin at a dose of 8g per liter of ascites removed after the procedure is completed 2
- For spontaneous bacterial peritonitis, administer 1.5 g/kg on day 1 and 1 g/kg on day 3 2
- For hepatorenal syndrome, administer albumin with vasoactive drugs 3
Hypovolemic Shock
- Adapt volume and infusion speed to the individual patient's response 1
- Monitor for signs of circulatory overload 1
Burns
- Aim to maintain plasma albumin concentration around 2.5 ± 0.5 g per 100 mL 1
- Duration of therapy is determined by protein loss from burned areas and in urine 1
Hypoproteinemia
- Usual daily dose is 50 to 75 g for adults and 25 g for children 1
- Do not exceed administration rate of 2 mL per minute to avoid circulatory embarrassment and pulmonary edema 1
Infusion Rate Considerations
- In patients with normal blood volume, administer slowly to prevent circulatory overload 1
- For hypoproteinemic patients, do not exceed 2 mL per minute 1
- For furosemide administered with albumin, infuse over 5–30 minutes to minimize ototoxicity 2
Monitoring During Administration
- Always monitor patients carefully to guard against circulatory overload 1
- In dehydrated patients, albumin must be given with or followed by additional fluids 1
- Monitor fluid status, electrolytes, blood pressure, and kidney function during administration 2
- For patients receiving regular albumin infusions via central venous lines, consider prophylactic anticoagulation 2
Special Considerations
- Albumin is compatible with whole blood, packed red cells, and standard carbohydrate and electrolyte solutions 1
- Do not mix with protein hydrolysates, amino acid solutions, or solutions containing alcohol 1
- In hemorrhage, supplement albumin administration with whole blood transfusion to treat relative anemia associated with hemodilution 1
- Home administration of albumin by trained caregivers is feasible and safe for selected patients requiring long-term therapy 2, 4