From the FDA Drug Label
Certain patients, e.g., those with a history of congestive cardiac failure, renal insufficiency or stabilized chronic anemia, are at special risk of developing circulatory overload. A history of an allergic reaction to albumin is a specific contraindication to usage. The absolute contraindications to Albumin infusion are:
- A history of allergic reaction to albumin 1
From the Research
Absolute contraindications to albumin infusion include hypersensitivity or allergic reactions to albumin or any component of the preparation, as well as severe heart failure, severe anemia, and severe protein-losing enteropathy or nephropathy. The most recent and highest quality study, 2, provides updated evidence-based instructions for the administration of albumin in clinical practice. Key points to consider when evaluating contraindications to albumin infusion include:
- Hypersensitivity or allergic reactions to albumin or any component of the preparation, which can lead to anaphylactic reactions 2
- Severe heart failure, as the volume expansion from albumin can worsen cardiac overload and potentially precipitate pulmonary edema in these patients 3, 4
- Severe anemia, because albumin does not carry oxygen and may dilute existing red blood cells, potentially worsening tissue oxygenation 2
- Severe protein-losing enteropathy or nephropathy, as albumin will be rapidly lost from circulation, rendering the treatment ineffective and potentially wasting resources 2 The physiological basis for these contraindications relates to albumin's oncotic properties, which draw fluid into the vascular space, and can be harmful in conditions where fluid overload already exists or where the patient cannot tolerate additional intravascular volume 2, 5. When considering albumin administration, clinicians should thoroughly assess the patient's cardiovascular status, fluid balance, and history of allergic reactions to ensure safe use of this blood product 2.