NORMAL SERUM ALBUMIN, HUMAN Pr

(al-byoo’min)

Albuminar, Albutein, Buminate, Plasbumin

Classifications: PLASMA DERIVATIVE; PLASMA VOLUME EXPANDER

Therapeutic: PLASMA VOLUME EXPANDER

Pregnancy Category: C

Availability: 5%, 20%, 25% injection

Action & Therapeutic Effect: Obtained by fractionating pooled

venous and placental human plasma, which is then sterilized by
filtration and heated to minimize transmitting hepatitis B or HIV.
Plasma volume expander that increases the osmotic pressure of
plasma. Expands volume of circulating blood by osmotically shifting
tissue fluid into general circulation.

Uses: To restore plasma volume and maintain cardiac output in

hypovolemic shock; for prevention and treatment of cerebral edema;
as adjunct in exchange transfusion for hyperbilirubinemia and
erythroblastosis fetalis; to increase plasma protein level in treatment
of hypoproteinemia; and to promote diuresis in refractory edema. Also
used for blood dilution prior to or during cardiopulmonary bypass
procedures. Has been used as adjunct in treatment of adult respiratory
distress syndrome (ARDS).

Contraindications: Hypersensitivity to albumin; severe anemia;

cardiac failure; within 24 h of severe burns; heart failure; patients with
normal or increased intravascular volume.

Cautious Use: Low cardiac reserve, pulmonary disease, absence of

albumin deficiency; liver or kidney failure, dehydration, hypertension,
hypernatremia; restricted sodium intake; pregnancy (category C).

Common adverse effects in italic, life-threatening effects underlined; generic names

in bold; classifications in SMALL CAPS; Canadian drug name; Pr Prototype drug

Wilson, B., Shannon, M. T., & Shields, K. M. (2012). Normal Serum Albumin, Human. In Pearson
Nurse's Drug Guide 2012 (pp. 1090–1092). Upper Saddle River, NJ: Prentice Hall. 1
Route & Dosage

Emergency Volume Replacement

Adult: IV 25 g, may repeat in 15–30 min if necessary (max: 250 g)

Colloidal Volume Replacement (Nonemergency)

Child: IV 12.5 g, may repeat in 15–30 min if necessary

Hypoproteinemia

Adult: IV 50–75 g (max: 2 mL/min)

Child: IV 25 g (max: 2 mL/min)

Administration

Intravenous

Prepare: IV Infusion: Normal serum albumin, 5%, is infused without

further dilution. • Normal serum albumin, 20% and 25%, may be
infused undiluted or diluted in NS or D5W (with sodium restriction).

Administer: IV Infusion for Hypovolemic Shock: Give initially as

rapidly as necessary to restore blood volume. As blood volume
approaches normal, rate should be reduced to avoid circulatory
overload and pulmonary edema. • Give 5% albumin at rate not
exceeding 2–4 mL/min. Give 20% and 25% albumin at a rate not to
exceed 1 mL/min. IV Infusion with Normal Blood Volume: Give
5% albumin human at a rate not to exceed 5–10 mL/min; give 20%
and 25% albumin at a rate not to exceed 2 or 3 mL/min. IV Infusion
for Children: Usual rate is 25%–50% of the adult rate.

Incompatibilities: Solution/additive: Amino acids, verapamil.

Y-site: Fat emulsion, midazolam, vancomycin, verapamil.

• Store at temperature not to exceed 37° C (98.6° F). • Use

solution within 4 h, once container is opened, because it contains
no preservatives or antimicrobials. Discard unused portion.

Adverse Effects (≥1%): Body as a Whole: Fever, chills, flushing,

increased salivation, headache, back pain. Skin: Urticaria, rash.
CV: Circulatory overload, pulmonary edema (with rapid infusion);
hypotension, hypertension, dyspnea, tachycardia. GI: Nausea, vomiting.

Wilson, B., Shannon, M. T., & Shields, K. M. (2012). Normal Serum Albumin, Human. In Pearson
2 Nurse's Drug Guide 2012 (pp. 1090–1092). Upper Saddle River, NJ: Prentice Hall.
Diagnostic Test Interference: False rise in alkaline phosphatase
when albumin is obtained partially from pooled placental plasma
(levels reportedly decline over period of weeks).

Nursing Implications

Assessment & Drug Effects

• Monitor BP, pulse and respiration, and IV albumin flow rate.
Adjust flow rate as needed to avoid too rapid a rise in BP.
• Lab tests: Monitor dosage of albumin using plasma albumin
(normal): 3.5–5 g/dL; total serum protein (normal): 6–8.4 g/dL;
Hgb; Hct; and serum electrolytes.
• Observe closely for S&S of circulatory overload and pulmonary
edema (see Appendix F). If S&S appear, slow infusion rate just
sufficiently to keep vein open, and report immediately to
prescriber.
• Monitor I&O ratio and pattern. Report changes in urinary output.
Increase in colloidal osmotic pressure usually causes diuresis,
which may persist 3–20 h.
• Withhold fluids completely during succeeding 8 h, when albumin
is given to patients with cerebral edema.

Patient & Family Education

• Report chills, nausea, headache, or back pain to prescriber
immediately.

Wilson, B., Shannon, M. T., & Shields, K. M. (2012). Normal Serum Albumin, Human. In Pearson
Nurse's Drug Guide 2012 (pp. 1090–1092). Upper Saddle River, NJ: Prentice Hall. 3