1. Plasma volume expander
2. Also expands interstitial fluid volume
3. Plasma volume effect is only temporary as most of the saline moves out of the blood vessels quite quickly

Albumin contributes substantially to plasma colloid oncotic pressure and thereby regulates plasma volume. Concentrated albumin solutions draw fluid from the interstitial space into the circulation.

Albumin accounts for 70% of plasma oncotic pressure. Carrier of hormones, enzymes, Mg2+ and Ca2+, and acidic drugs.

Albumin accounts for 70% of plasma oncotic pressure. Carrier of hormones, enzymes and drugs.

Expands plasma volume. The haemodynamic effect depends on baseline circulating volume and capillary permeability. Concentrated 20-25% albumin may recruit several times the administered volume into the circulation over a short period.

CVS: Dependent on circulating volume status. Raised plasma oncotic pressure may lead to 3x the administered volume being dragged into the plasma within 15min.

CVS: Dependent on circulating volume status.

IV. BA 100%

~15mins:
ISF 750mls
Plasma volume 250mls.
Not distributed to ICF

Under normal circumstances 40% of albumin is intravascular and 60% is extravascular

Unmetabolized

Breakdown is predominantly by intracellular lysosome proteases under feedback control

Excreted by kidney
Slower than balanced solutions

Albumin normally has a T1/2 of 19 days

1. Fluid overload
2. hyperchloremic metabolic acidosis
3. increased risk of renal failure compared to balanced solutions
4. Injury to endothelial glycocalyx

1. Risk of Creutzfeldt Jakob Disease and Parvovirus B19 (Resistant to heat treatment)
2. Pulmonary oedema
3. Has been associated with myocardial depression
4. Contraindicated in TBI

Crystalloid

Human albumin, a fractionated plasma product used clinically as a colloid.

Colloid

Fractionated Plasma Product

1. Initial replacement fluid, in volume depleted or dehydrated patients. Volume depletion may be due to loss of blood, plasma or fluid and electrolytes.
2. Maintenance of hydration during prolonged patient contact time.
3. To keep vein open, as IV route for drugs.

Plasma-volume replacement, priming of extracorporeal circuits, treatment of hypoalbuminaemic states and replacement fluid during therapeutic plasma exchange.

1. Hypoproteinaemia
2. Shock
3. Burns
4. ARDS
5. Plasma exchange

1. Volume replacement
2. Priming of extracorporeal circuits
3. Treatment of hypoalbuminaemic states
4. Replacement fluid during plasma exchange
5. Spontaneous bacterial peritonitis

intravenous fluid with 9g NaCl in litre of sterile water.
Isotonic crystalloid solution

Natural Colloid

Level 1

Level 1

500 or 1000mls of 0.9% Sodium Chloride solution in a collapsible plastic flask or bag.

Clear, straw-coloured human albumin solution available in approximately 4.5-5% and 20-25% preparations. The referenced text describes pasteurisation at 60 C for 10 hours, no preservatives and sodium content around 130-160 mmol/L.

- Heat treated human albumin
200ml bottles containing 200g/L. Straw coloured clear solution.
- Shelf life of 4 years
- Should be stored <30’C
- Heat treated at 60’C for 10 hours (pasteurized) and incubated at low pH
- Contains sodium chloride and water for injection
- 20% is hyperoncotic with approximately the equivalence of approximately 4x its volume in plasma

- Heat treated human albumin
500ml bottles containing 10g albumin.
- Straw-coloured clear solution.
- Shelf life of 4 years
- Should be stored <30’C
- Heat treated at 60’C for 10 hours (pasteurized) and incubated at low pH
- Contains sodium chloride and water for injection
- 4% is iso-oncotic

pH 5.0
Osm 308
Tonicity 286

Na 154
Cl 154

Clinical volume expansion is variable, especially in states with increased capillary permeability. Monitor for circulatory overload when administering albumin solutions.

pH 6.7-7.3
Osm 260

Na 100

Albumin 200gm/L (20gm in 100ml)

Na 140
Cl 128

Albumin 40gm/L (20gm in 500ml)