2017 Volume 24 Issue 6 Pages 613-617
In recent years, the number of studies on albumin and its use in critically ill patients has been increasing, and these studies have provided important insights into the clinical use of albumin for the treatment of different pathological conditions. Although many clinical studies involving the administration of albumin during the acute phase, with a target serum albumin level of 2.5 to 3.0 g/dl, have been reported, the superiority of albumin treatment has not been demonstrated. In patients with a decreased intravascular volume or severe sepsis, the use of albumin is not associated with an improvement in the mortality rate, compared with the use of crystalloids. Furthermore, the efficacy of albumin for fluid resuscitation in patients with traumatic brain injury or for the initial treatment of acute stroke has not received evidence-based support. In the former situation, a poorer prognosis has actually been noted. On the other hand, albumin is superior to other plasma expanders for preventing circulatory failure and for reducing mortality after large-volume paracentesis. Therapeutic plasma exchange using albumin as a replacement fluid is an effective treatment for neurological disorders. At present, no clear thresholds for albumin administration exist, and the decision to use albumin products should be made after careful consideration of the disease and the patient's condition.
