Use of Albumin in the Critical Care Setting

Abstract

Albumin is the main determinant of oncotic pressure and the body´s most abundant plasma protein. The conditions regulating the rate of albumin synthesis are basically: oncotic pressure, nutritional status and hormones. Hypoalbuminemia is associated with poor clinical outcomes, mainly in critically ill patients, so exogenous administration is an attractive and widely used therapeutic strategy, although this entails risk of complication and even death. In the context of the critical patient, albumin has been used with treatment functions, nutritional status assessment and as a predictor of mortality or complications. Despite the existing literature, no agreement has been reached on the indications for the use of albumin, since in the different clinical contexts (resuscitation, sepsis, postoperative, burned, nephrotic syndrome, adult respiratory distress syndrome), there are no significant advantages in terms of morbidity and mortality when comparing its use with that of crystalloids or other synthetic colloids, not to mention also the economic cost of its use.