What is the difference between 25 albumin and 5 albumin

Albumin may be prescribed as a bolus dose, where a patient requires an Albumin infusion over a discrete period of time and the total dose is known. A continuous infusion is sometimes used when a patient needs an Albumin infusion for an extended period of time and when the clinician does not know exactly when the infusion will cease.

In this instance it should be prescribed as a regular administration e. Two clinicians must independently complete the patient and blood product identification check at the bedside. Record the batch number and expiry date of each bottled infused in the medical record.

Staff administering Albumin must also record the date, time and volume infused. Administer via a standard intravenous IV giving set. It does not require a transfusion filter. The manufacturer recommends that each bottle of Albumin is used immediately after opening the bottle as it does not contain antimicrobial preservative.

At RCH we allow the product to be administered within 6 hours of piercing the bottle. Temperature, heart rate, respiration rate, blood pressure and SpO2 should be recorded at baseline, hourly, at every change in bottle and upon completion.

More frequent observations as the clinical condition of the patient requires. Mild reactions such as mild hypotension, flushing, urticaria, fever and nausea usually disappear when the infusion rate is slowed or ceased. The advantages of crystalloid therapy over most colloid solutions include decreased expense, increased urine output and a simpler chemical structure that is easily metabolized and excreted. The disadvantages of crystalloids are primarily seen in situations requiring large volumes for clinical resuscitation, which may lead to peripheral and pulmonary edema, and a potential for hyperchloremia in patients with renal dysfunction.

Colloids differ from crystalloids in that they have an increased ability to hold water in the intravascular compartment. If there is normal membrane permeability, colloids do not enter interstitial or intracellular compartments and may preferentially increase plasma volume.

In addition to albumin, colloids currently available in Canada for therapeutic use include:. Although other colloids such as HES products are cheaper than albumin, they may be associated with increased side effects. The reading of one chapter is equivalent to two credits. Please contact us through the Clinical Guide feedback form.

Clinical Guide to Transfusion. Chapter 3. Chapter 3 - Albumin. Author s :. Monday, June 4, Background This chapter describes when and how to use the plasma protein product albumin and introduces therapeutic alternatives to albumin. Efficacy and Safety of Albumin Albumin purified from human plasma has been used as a therapeutic agent since the s, despite ongoing controversy regarding its efficacy and safety compared with other colloids and crystalloids.

Indications In , the University Hospital Consortium in the United States developed the first consensus statement on indications for albumin use. Contraindications Albumin is contraindicated in: Patients who would not tolerate a rapid increase in circulating blood volume. Patients with a history of an allergic reaction to albumin. Dose and Administration The volume and rate of infusion should be determined by the clinical situation.

Once opened, the vial of albumin should be discarded if not infused within four hours. Storage and Transportation See Table 1 for storage temperatures for the various albumin preparations available through Canadian Blood Services.

The product should not be administered if it is expired or if: the solution has been frozen or otherwise stored under inappropriate conditions; the solution is turbid or contains particulate material e. Alternatives to Albumin Alternatives to albumin therapy include other colloid solutions and crystalloids. Generally, plasma volume-expanding therapeutic agents used clinically can be classified into three broad categories: crystalloid colloid e.

Storage: Administer within 4 hours of entering the container. More rapid administration can cause circulatory overload and pulmonary edema. Generic: - Store below 86 degrees F Albuked : - Avoid temperatures above 86 degrees F - Discard product if it contains particulate matter, is cloudy, or discolored - Discard unused portion. Do not store for later use.

Albumarc: - Avoid temperatures above 86 degrees F - Discard product if it contains particulate matter, is cloudy, or discolored - Discard unused portion. Albuminar: - Discard product if it contains particulate matter, is cloudy, or discolored - Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees F Albuminex: - Avoid temperatures above 86 degrees F - Discard product if it contains particulate matter, is cloudy, or discolored - Do not freeze - Protect from light - Store in carton AlbuRx : - Discard product if it contains particulate matter, is cloudy, or discolored - Store at room temperature not exceeding 86 degrees F Albutein: - Avoid temperatures above 86 degrees F - Discard product if it contains particulate matter, is cloudy, or discolored - Discard unused portion.

Buminate: - Avoid temperatures above 86 degrees F - Discard product if it contains particulate matter, is cloudy, or discolored - Discard unused portion. Flexbumin: - Discard product if it contains particulate matter, is cloudy, or discolored - Discard unused portion.

Macrotec: - Refrigerate between 36 and 46 degrees F Plasbumin: - Avoid temperatures above 86 degrees F - Discard product if it contains particulate matter, is cloudy, or discolored - Discard unused portion. Use of albumin is contraindicated in patients with a history of albumin hypersensitivity or hypersensitivity to any of the excipients.

Discontinue administration immediately and institute appropriate medical treatment if a hypersensitivity reaction is suspected. Albumin is contraindicated in patients with severe anemia or heart failure with normal or increased intravascular volume.

Monitor coagulation and hematology parameters when large volumes are replaced. Ensure adequate substitution of other blood constituents e. Monitor electrolyte status and take appropriate steps to address electrolyte imbalance. Discontinue albumin administration at the first sign of cardiovascular overload e. Albumin increases plasma volume and can cause vascular overload, especially after rapid infusion. Monitor blood pressure in trauma and postoperative surgery patients in order to detect rebleeding secondary to clot disruption.

Closely monitor hemodynamic parameters for evidence of increased intracranial pressure and cardiac, respiratory, or renal failure in all patients.

Accumulation at concentrations associated with central nervous system and bone toxicity is more likely to occur in patients with renal disease or in premature neonates with immature kidneys. Albumin is a derivative of human blood. As with other products derived from or purified with human blood components, the remote possibility of contamination with Creutzfeldt-Jakob disease CJD or other viral infections exists in patients receiving albumin. The manufacturing processes are designed to reduce the risk of transmitting viral infection.

No cases of transmission of viral illness or CJD have ever been identified for albumin. Report all infections thought to have been transmitted by albumin to the manufacturer. Patients with marked dehydration require the administration of additional fluids when treated with concentrated albumin. Monitor patients carefully to guard against circulatory overload and hyperhydration.