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In general, the dosage and infusion rate should be adjusted to the patient's individual requirements. The infusion rate should, as a rule, not exceed 1-2 ml per minute.
When human albumin is used in replacement therapy, the dosage required is guided by the usual circulatory parameters. The lowest limit for the colloidal osmotic pressure is 20 mm Hg (2.7 kPa). It is recommended to monitor the protein concentration achieved.
For administration the required dose in grams can be estimated using the following calculation: [Required total protein (g/l)-actual total protein (g/l)] x plasma volume (l) x 2
Physiological plasma volume may be taken as approximately 40 ml per kg bodyweight.
* HIV-PCR is a quality-assured PCR testing program for genome equivalents of HIV-1 and -2, HBV, and HCV.
HIQ-PCR stands for Hyland Immuno Quality-Assured Polymerase Chain Reaction.
Pediatric use: In children the physiological plasma volume is age-dependent; this fact must be taken into account.
In cases of extensive substation or with haematocrit below 30%, packed red should be given to maintain the oxygen transport capacity of blood.
Pre and Postoperative Treatment: Adults: 100 to 200 ml (20 to 40 g) of Human Albumin daily or diluted to 5%, depending on plasma volume and serum albumin level of the patient. The dosage and duration of this substitution therapy depends on the amount of protein loss and should be continued until the serum concentration returns to normal.
Children: 1.5 to 3 ml (0.3 to 0.6 g) Human Albumin per kg bodyweight daily or diluted to a 5% solution. In hypoproteinemia multiple administration of albumin might be necessary until the plasma protein level has returned to normal.
Hepatic Cirrhosis: Adults: 100 to 200 ml (20 to 40 g) of Human Albumin daily.
Infants and children: 1.5 to 3 ml (0.3 to 0.6 g) Human Albumin per kg bodyweight.
Nephrotic Syndrome: Adults: 200 to 400 ml (40 to 80 g) of Human Albumin daily.
Infants and children: 3 to 6 ml (0.6 to 1.2 g) Human Albumin per kg bodyweight.
The dose should be infused over a period of 60 to 90 minutes.
Oedema in patients with albumin deficiency: Adults: 100 ml (20 g) of Human Albumin.
Children: 2 ml (0.4 g) Human Albumin per kg bodyweight.
Fluid Loss into the Extravascular Compartment: Adults: 50 to 200 ml (10 to 40 g) of Human Albumin.
Children: 1 to 2 ml (0.2 to 0.4 g) Human Albumin per kg bodyweight.
The initial dose should be infused over a period of 5 to 15 minutes.
Shock due to blood loss: Adults: 50 to 200 ml (10 to 40 g) of Human Albumin diluted 1:4 with isotonic electrolyte and/or dextrose solution (corresponding to 200-800 ml of a 5% albumin solution).
Children: 1 to 2 ml (0.2 to 0.4 g) Human Albumin per kg bodyweight diluted 1:4 with isotonic electrolyte and/or dextrose solution (corresponding to 4-8 ml of a 5% albumin solution).
In cases of severe blood loss, an initial dose of 20 g albumin (i.e. 400 ml o f a 5% albumin solution should be infused rapidly (5 to 15 minutes).
If insufficient to control the shock, this dose should be repeated. The amount of diluted albumin to be administered depends on the severity of blood loss. The quantity given should restore blood pressure, pulse rate, and venous pressure to normal.
Burns with Increased Haematocrit: Adults: 200 to 400 ml (40 to 80 g) of Human Albumin diluted 1:4 with isotonic electrolyte and/or dextrose solution (corresponding to 800-1600 ml of a 5% albumin solution).
Children: 4 ml (0.8 g) Human Albumin per kg bodyweight diluted 1:4 with isotonic electrolyte and/or dextrose solution (corresponding to 16 ml of a 5% albumin solution).
The dosage of human albumin used as colloidal volume replacement has to be adjusted to the burn victim's clinical needs.
After the acute stage has been brought under control, considerable protein deficiency, largely of albumin, may occur. This hypoalbuminemia can be corrected by administration of the following doses.
Adults: 50 ml (10 g) of Human Albumin twice a day.
Children: 1 ml (0.2 g) Human Albumin per kg bodyweight twice a day.
Method of Administration: HUMAN ALBUMIN must be administered intravenously. If large volumes are administered, the product should be warmed to room or body temperature before use. HUMAN ALBUMIN contains no isoagglutinins or blood group substances; it may thus be administered regardless of the patient's blood group or Rhesus factor.
Do not use after the expiry date given on the label.
Usually the solution is clear or slightly opalescent. Do not use solutions that are cloudy or have deposits.
Once the infusion bottle has been opened, the contents should be used immediately. Any unused solution must be discarded appropriately.
Albumin solutions should not be mixed with protein hydrolysates or solutions containing alcohol since these combinations may cause the proteins to precipitate.
Do not add supplementary medication.
Hypervolemia may occur if the dosage and rate of infusion are not adjusted, giving consideration to the solution concentration and the patient's clinical status. Hemodynamic parameters should be monitored in patients receiving HUMAN ALBUMIN and should be used to check for the risk of hypervolemia and cardiovascular overload. (See Precautions).
