Overview
Natural colloid from human plasma. 25% solution is hyperoncotic. Used for hypoalbuminemia, large-volume paracentesis, burns. Expensive with limited evidence for most indications.
Dosing
Hypoalbuminemia: 25g IV (5% or 25%) Paracentesis: 6-8g/L removed Burns: 5% solution Nephrotic syndrome: 25% with diuretics Max dose: Limited by volume status
Pharmacokinetics
Onset: Immediate Duration: 12-24 hr intravascular Distribution: Intravascular space Osmolarity: 5%: 290 mOsm/L 25%: 1500 mOsm/L
Pharmacodynamics
Mechanism: Oncotic pressure expansion Effects: - Expands intravascular volume - Binds medications - Transports hormones - Antioxidant properties
Clinical Considerations
Clinical Pearls: 1. Use 25% with diuretics for mobilization 2. Monitor for pulmonary edema 3. Expensive with limited benefit 4. First-line for large-volume paracentesis 5. Not for routine resuscitation 6. Risk of TRALI 7. Store at room temperature 8. Shortage concerns