From the Guidelines
Albumin infusion is contraindicated in patients with traumatic brain injury [ 1 ], as well as those with severe anaphylactic reactions to albumin, cardiac failure, severe pulmonary edema, and hemorrhagic shock.
Key Contraindications
- Traumatic brain injury: due to increased mortality when albumin is used for resuscitation [ 1 ]
- Acute ischemic stroke: as high-dose albumin infusion has shown no benefit and a higher rate of pulmonary edema [ 1 ]
- Severe anaphylactic reactions to albumin: a clear contraindication due to the risk of severe allergic reactions
- Cardiac failure: as albumin infusion can exacerbate fluid overload and worsen cardiac function
- Severe pulmonary edema: as albumin infusion can worsen fluid overload and exacerbate pulmonary edema
- Hemorrhagic shock: as albumin infusion is not recommended in this setting due to the risk of worsening outcomes
Additional Considerations
- Patients with a history of allergic reactions to albumin, including those who have received albumin-containing products, should also be excluded from receiving albumin infusions
- Albumin infusion should be used with caution in patients with cirrhosis and ascites, as it may not be beneficial in all cases and can increase the risk of fluid overload [ 1, 1 ]
From the Research
Contraindications for Albumin (Human Albumin) Infusion
The following are contraindications for Albumin (Human Albumin) infusion:
- Hypersensitivity reactions, including anaphylactoid shock and anaphylaxis, have been reported with the use of human serum albumin 2, 3
- Patients with a history of allergic reactions to human serum albumin or other plasma proteins should not receive albumin infusion
- Albumin infusion is not recommended for patients with hypoalbuminemia or for nutritional purposes 4
- Caution should be exercised when administering albumin to patients with congestive heart failure and hypoalbuminemia, as it may increase the risk of in-hospital mortality, longer ICU and hospital stays 5
- Patients with severe cardiac or pulmonary disease should be closely monitored during albumin infusion, as it may exacerbate these conditions 6
Precautions and Warnings
When administering albumin infusion, the following precautions and warnings should be considered:
- Monitor patients for signs of hypersensitivity reactions, including anaphylactoid shock and anaphylaxis
- Use caution when administering albumin to patients with a history of allergic reactions or hypersensitivity to human serum albumin or other plasma proteins
- Monitor patients with congestive heart failure and hypoalbuminemia for increased risk of in-hospital mortality, longer ICU and hospital stays
- Closely monitor patients with severe cardiac or pulmonary disease during albumin infusion
Adverse Reactions
Adverse reactions to albumin infusion have been reported, including:
- Hypersensitivity reactions, including anaphylactoid shock and anaphylaxis 2, 3
- Alterations in coagulation, renal, cardiovascular, and pulmonary functions 6
- Trace metal loading and serum amino acid alterations 6
- Increased risk of in-hospital mortality, longer ICU and hospital stays in patients with congestive heart failure and hypoalbuminemia 5