Uses Of Albumin
FLEXBUMIN 25% [Albumin (Human)], 25% Solution is indicated for the treatment of:1
- Adult Respiratory Distress Syndrome
- Cardiopulmonary Bypass Surgery
- Hemolytic Disease of the Newborn
Hypovolemia is a possible indication for albumin. Its effectiveness in reversing hypovolemia depends largely upon its ability to draw interstitial fluid into the circulation. It is most effective with patients who are well hydrated.
When hypovolemia is long standing and hypoalbuminemia exists accompanied by adequate hydration or edema, 25% albumin is preferable to 5% protein solutions. However, in the absence of adequate or excessive hydration, 5% protein solutions should be used or 25% albumin should be diluted with crystalloid.
Although crystalloid solutions and colloid-containing plasma substitutes can be used in emergency treatment of shock, albumin has a prolonged intravascular half-life. When blood volume deficit is the result of hemorrhage, compatible red blood cells or whole blood should be administered as quickly as possible.1
Hypoalbuminemia can result from one or more of the following:
(1) Inadequate production (malnutrition, burns, major injury, infections, etc.)
(2) Excessive catabolism (burns, major injury, pancreatitis, etc.)
(3) Loss from the body (hemorrhage, excessive renal excretion, burn exudates, etc.)
(4) Redistribution within the body (major surgery, various inflammatory conditions, etc.)
When albumin deficit is the result of excessive protein loss, the effect of administration of albumin will be temporary unless the underlying disorder is reversed. In most cases, increased nutritional replacement of amino acids and/or protein with concurrent treatment of the underlying disorder will restore normal plasma albumin levels more effectively than albumin solutions. Occasionally hypoalbuminemia accompanying severe injuries, infections or pancreatitis cannot be quickly reversed and nutritional supplements may fail to restore serum albumin levels. In these cases, albumin human serum might be a useful therapeutic adjunct.1
An optimum regimen for the use of albumin, electrolytes and fluid in the early treatment of burns has not been established; however, in conjunction with appropriate crystalloid therapy, albumin may be indicated for treatment of oncotic deficits after the initial 24 hour period following extensive burns and to replace the protein loss which accompanies any severe burn.1
A characteristic of ARDS is a hypoproteinemic state, which may be causally related to the interstitial pulmonary edema. Although uncertainty exists concerning the precise indication of albumin infusion in these patients, if there is a pulmonary overload accompanied by hypoalbuminemia, 25% albumin solution may have a therapeutic effect when used with a diuretic.1
Albumin may be a useful aid in treating edema in patients with severe nephrosis who are receiving steroids and/or diuretics. 1
Albumin has been recommended prior to or during cardiopulmonary bypass surgery, although no clear data exist indicating its advantage over crystalloid solutions. 1
Albumin may be administered in an attempt to bind and detoxify unconjugated bilirubin in infants with severe HDN.1
FLEXBUMIN 25% [Albumin (Human)]
FLEXBUMIN 25% [Albumin (Human)], USP, 25% Solution is a sterile, nonpyrogenic preparation of albumin in a single dosage form for intravenous administration. FLEXBUMIN 25% is indicated for hypovolemia, hypoalbuminemia due to general causes, burns, adult respiratory distress syndrome (ARDS), and nephrosis, and for use during or prior to cardiopulmonary bypass surgery, and hemolytic disease of the newborn (HDN).
Important Risk Information for FLEXBUMIN 25%
FLEXBUMIN 25% is contraindicated in patients with cardiac failure, in patients with severe anemia and in patients with a history of allergic reactions to human albumin.
Do not use if turbid. Do not begin administration more than 4 hours after the container has been entered.
Do not use Sterile Water for Injection as a diluent. There exists a risk of potentially fatal hemolysis and acute renal failure from the inappropriate use of Sterile Water for Injection as a diluent for FLEXBUMIN 25%. Acceptable diluents include 0.9% Sodium Chloride or 5% Dextrose in Water.
FLEXBUMIN 25% is made from pooled human plasma. It may carry a risk of transmitting infectious agents, e.g., viruses and theoretically, the Creutzfeldt–Jakob disease (CJD) agent.
FLEXBUMIN 25% must be administered intravenously at a rate not to exceed 1 mL/min to patients with normal blood volume, due to the risk of developing circulatory overload and pulmonary edema.
When 25% albumin is infused, a rise in blood pressure necessitates careful observation to detect and treat severed blood vessels that may not have bled at a lower blood pressure.
Adverse reactions to FLEXBUMIN 25% are extremely rare, although nausea, fever, chills or urticaria may occasionally occur.
CAUTION: Do not use plastic containers in series connections. Such use could result in air embolism due to residual air being drawn from the primary container before the administration of the fluid from the secondary container is complete.
Please see Preparation for Administration for FLEXBUMIN 25% in the Prescribing Information.
Please review the FLEXBUMIN 25% [Albumin (Human)] Prescribing Information for full prescribing details.
- FLEXBUMIN 25% [Albumin (Human)], 25% Solution [package insert]. Westlake Village, CA: Baxter Healthcare Corporation; September 2009.