Albapure 20
Indication
Hypoproteinaemia in the Acutely Ill Patient
Albapure 20 is administered when there are existing or anticipated clinical problems or complications from reduced oncotic pressure, and/or as an adjunct to diuretic therapy.
Shock
Albapure 20 may be used for the resuscitation of patients in shock due to acute loss of blood or plasma.
Severe Burns
Extensive burns are followed by sequential shifts in the distribution of body water, salt and proteins, resulting in hypovolaemic shock and circulatory failure.
Iso-oncotic albumin solution is the preferred replacement material. If the patient’s serum albumin level is not maintained, concentrated albumin (20%) may be indicated. If exchange occurs less frequently than once a week, less concentrated colloids may be appropriate.
Composition
Human Albumin 20.000 mg
Package
Dosage Forms
ATC Classification
Warning
Dosage
For All Ages
The dose required depends on the size of the patient, the severity of trauma or illness, and on continuing fluid and protein losses. Measures of adequacy of circulating volume and not plasma albumin levels should be used to determine the dose required. If human albumin is to be administered, haemodynamic performance should be monitored regularly; this may include:
- arterial blood pressure and pulse rate
- central venous pressure
- pulmonary artery wedge pressure
- urine output
- electrolyte
- haematocrit/haemoglobin
Monitoring Advice
It is recommended that blood pressure is monitored during administration of Albapure 20. To avoid circulatory overload the rate and volume of infusion should be monitored frequently. Myocardial function should also be monitored e.g. central venous pressure, arterial pressure and pulse rate. It is also recommended that plasma electrolytes, prothrombin time, biochemistry and haematological status should be monitored.
Hypoproteinaemia in the Acutely Ill Patient
The usual daily dose is 50-75 g human albumin (250-375 ml of Albapure). The rate of administration should not exceed 2 ml per minute, as more rapid infusion may precipitate circulatory overload and pulmonary oedema. The infusion of Albapure is not justified in hypoproteinaemic state associated with chronic cirrhosis, malabsorption, protein losing enteropathies, pancreatic insufficiency or undernutrition.
Severe Burn
The usual dose is 20-80 g human albumin (100-400 ml of Albapure) given daily at the rate of about 1 ml per minute. Beyond 24 hours, Albapure can be used to maintain plasma colloid osmotic pressure. A reasonable goal is the maintenance of a plasma albumin concentration of 25 g/l or a colloid osmotic pressure of 20 mmHg. The continuing need for albumin is occasioned by losses from denuded areas and decreased albumin synthesis.
Shock
The precise nature and strength of the crystalloid solution will depend on the requirements of the patient for electrolytes and fluid. The dose should be determined by the patient’s condition and response to treatment. The usual initial dose of 20 g human albumin (100 ml of Albapure) may be administered as a blood volume expander at a rate of 2 to 4 ml per minute. The rate of infusion may be increased in emergencies and repeated in 15 to 30 minutes if necessary. The total dose should not exceed the level of albumin found in the normal individual i.e. about 2 g per kg body weight in the absence of active bleeding.