Critical Matters Albumin in Critical Care
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Sep 30, 2024 D. Jeannie Callum, Director of Transfusion Medicine and Professor at Queens University, dives deep into the complexities of intravenous albumin use in critical care. She discusses emerging evidence that questions its safety and efficacy, alongside challenges of inconsistent practices worldwide. Callum also addresses the financial implications and potential risks associated with albumin, especially in vulnerable patient groups. The conversation underlines the necessity of solid evidence and patient inclusion in treatment guidelines for better healthcare outcomes.
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Limited Albumin Benefits in ARDS and Burns
- Albumin combined with diuretics can reduce weight in ARDS but does not improve ventilator or ICU outcomes.
- Albumin shows no clear benefit in burns below 40% total body surface area, with potential niche use in large burns after 24 hours.
Never Treat Low Albumin Numerically
- Never treat low serum albumin levels by giving intravenous albumin.
- Low albumin levels indicate severity but albumin infusion does not improve outcomes.
No Current Support for Albumin in Dialysis
- Evidence does not support albumin for preventing hypotension or improving ultrafiltration during renal replacement therapy.
- Large trials like the ALTER AKI study are underway to clarify potential benefits.