From the FDA Drug Label
The aim should be to maintain the plasma albumin concentration in the region of 2.5 ± 0.5 g per 100 mL The usual daily dose of albumin for adults is 50 to 75 g and for children 25 g. Patients with severe hypoproteinemia who continue to lose albumin may require larger quantities
The patient's albumin level is 2.6 g per 100 mL, which is within the target range of 2.5 ± 0.5 g per 100 mL. No albumin administration is necessary at this time, as the patient's albumin level is already within the desired range. However, the patient's condition should be closely monitored, and albumin administration may be considered if the patient's albumin level decreases or if they continue to lose albumin 1.
From the Research
I recommend administering 25g of albumin (typically as 100mL of 25% albumin solution) if the serum albumin level is 2.6 g/dL, which is below the normal range of 3.5-5.0 g/dL. This dose can be given intravenously over 30-60 minutes, and may need to be repeated daily until albumin levels normalize. Before administering albumin, it's essential to determine the underlying cause of hypoalbuminemia, as simply replacing albumin without addressing the root cause (such as liver disease, malnutrition, or protein-losing conditions) will not provide lasting benefit 2. Monitor for potential side effects during administration, including fluid overload, hypertension, or allergic reactions. Albumin replacement is most beneficial in specific clinical scenarios like large volume paracentesis, spontaneous bacterial peritonitis, or hepatorenal syndrome, rather than for asymptomatic hypoalbuminemia alone 3. The goal is to improve oncotic pressure, which helps maintain fluid in the vascular space and reduces edema in tissues. However, it's crucial to note that the use of intravenous albumin is not without controversy, and its effectiveness as a volume expander is not as significant as assumed, with potential risks and high costs 3. Therefore, the decision to administer albumin should be made on a case-by-case basis, considering the individual patient's needs and underlying conditions. Additionally, addressing the underlying cause of hypoalbuminemia, such as nutritional barriers or inflammation, is crucial for improving albumin levels and overall patient outcomes 4.