Editorials

Wonderful albumin?

Albumin solutions are commonly used to treat low serum albumin concentrations and hypovolaemia. Human albumin effectively replaces volume and supports colloid oncotic pressure. Unlike synthetic colloids, it has transport functions and binds reversibly with anions, cations, and some substances that are active or toxic only in the free form. It is a scavenger of free radicals¹ and improves prognosis in the sheep model of the adult respiratory distress syndrome.² It has anticoagulant properties, inhibiting platelet aggregation and enhancing the inhibition of factor Xa by antithrombin III.^{3 4} It may also have a role in preserving microvascular integrity, which is possibly mediated by glycoproteins distributed through the capillary membrane.⁵

Common reasons for using albumin rather than synthetic alternatives are generally clinical associations and beliefs related to the importance of hypoalbuminaemia. Hypoalbuminaemia is associated with a poor surgical outcome and a longer stay in hospital . . . [Full text of this article]

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Relevant Article

Use of albumin

Nigel G B Richardson and Denise F O'Shaughnessy
BMJ 1995 311: 129. [Extract] [Full Text]

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• Boldt, J. (2000). The Good, the Bad, and the Ugly: Should We Completely Banish Human Albumin from Our Intensive Care Units?. Anesth. Analg. 91: 887-895 [Abstract] [Full text]  
• Gosling, P. (2000). Albumin: friend or foe?. Trauma 2: 125-134 [Abstract]  
• Bormer, O. P., Amlie, L. M., Paus, E., Kongsgard, U. (1999). Automated Albumin Method Underestimates Pharmaceutical-Grade Albumin in Vivo. Clin. Chem. 45: 1082-1084 [Full text]  
• McClelland, B. (1998). Albumin: don't confuse us with the facts. BMJ 317: 829-830 [Full text]  
• Petros, A., Schindler, M., Pierce, C., Jacobe, S., Mok, Q., Nel, M. R, Nadel, S., Marriage, S., De Munter, C., Britto, J., Habibi, P., Levin, M., Kaag, M, Zoetmulder, F A N, Riordan, F A. I, Williams, A., Thomson, A. P J, Soni, N., Goodman, N. W, Beale, R J, Wyncoll, D L A, McLuckie, A, Frame, J D, Moiemem, N, Chalmers, I., Lawler, P G, Morgan, G A, Shwe, K H, Bhavnani, M, Roberts, I. (1998). Human albumin administration in critically ill patients. BMJ 317: 882-882 [Full text]  
• Reviewers, C. I. G. A., Reviewers, C. I. G. A. (1998). Human albumin administration in critically ill patients: systematic review of randomised controlled trials • Why albumin may not work. BMJ 317: 235-240 [Abstract] [Full text]