ALBUMIN: Action, Uses, Administration, Side effects, Nursing considerations, Nursesnote

ALBUMIN

Action

Blood volume expander. 

Therapeutic effect: Provides temporary increase in blood volume, reduce hemoconcentration and blood viscosity. 

Pharmacokinetics

Route: IV

Onset: 15 min (in well-hydrated patient )

Peak: N/A

Duration: Dependent on initial blood volume 

Distributed throughout extracellular fluid. 

Half-life: 15-20 days. 

Uses

Used for plasma volume expansion, maintenance of cardiac output in treatment of shock or impending shock. May be useful in treatment of severe burns, acute respiratory distress syndrome (ARDS), cardiopulmonary bypass, hemodialysis 

Precautions 

Contraindications: Heart failure, severe anaemia. 

Cautions: patient for whom sodium restriction in necessary, hepatic/renal failure. 

Lifespan considerations 

Pregnancy/lactation: Unknown if drug crosses placenta or is distributed in breast milk. 

Pregnancy category- C. 

Children/Elderly: No age-related precautions noted. 

Interactions 

Drug: None significant. HERBAL: None significant. FOOD: None known. LAB VALUES: May increase serum alkaline phosphate. 

Administration/Handling 

Rate of administration: Give by IV infusion. Rate is variable, depending on use, blood volume, concentration of solute. 5%: Do not exceed 2-4 ml/min in pts with normal plasma volume, 5-10 ml/min in pts with hypoproteinemia. 25%: Do not exceed 1 ml/min in pts with normal plasma volume, 2-3 ml/min in pts with hypoproteinemia.  5% is administered undiluted; 25% may be administered undiluted or diluted. 

Indication/Routes /Dosage

5% should be used in hypovolemic or intravascularly depleted pts. 25% should be used in pts in whom fluid and sodium intake must be minimized. 

Usual Dosage

IV adults, Elderly: Initially, 25g; may repeat in 15-30 min. Maximum: 250 g within 48 hrs.

Hypovolemia 

IV: Adults, Elderly: 5% albumin: 0.5 -1 g/kg/dose (10-20 ml/kg/dose of 5% albumin ). Maximum: 6g/kg/day.

Hypoproteinemia 

IV: Adults, Elderly, Children: 0.5-1g/kg/dose, repeat every 1-2 days as needed to replace ongoing losses.

Hemodialysis 

IV: Adults, Elderly: 50 - 100 ml (12.5-25g) of 25% albumin as needed.

Adverse Effects 

Fluid overload may occur, marked by increased B/P, distended neck veins, pulmonary oedema may occur, evidenced by labored respirations, dyspnea, rales, wheezing, coughing, neurological changes that may occur include headache, weakness, blurred vision, behavioural changes, incoordination, isolated muscle twitching. 

Nursing Considerations 

Baseline Assessment 

Obtain B/P pulse, respirations immediately before administration. Adequate hydration required before albumin is administered.