Use of Albumin as a Resuscitative Fluid in the Intensive Care Unit

Author(s): Nicolas Tran, PharmD, BCPS, Christopher Allen, PharmD

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Activity Summary

Required reading for all learners: Implicit Bias impacts patient outcomes

Crystalloid solutions have predominately been used as initial resuscitative fluids in critically ill patients. Since the first clinical use of a human albumin solution was documented in 1941, clinicians and researchers have evaluated the use of albumin and other colloids as compared with crystalloids. Albumin has fallen out of favor for some clinicians because of the lack of clinical benefits over crystalloids in multiple large randomized controlled trials and the cost of albumin compared with alternative fluids. With over 35% of patients receiving fluid resuscitation on any given day in the intensive care unit, understanding the nuances between resuscitative fluids is paramount to caring for the critically ill patient because no ideal fluid exists. The purposes of this article are to review the role of albumin as a resuscitation fluid and to highlight the considerations of its use for the critical care nurse.

Objectives

  • Discuss the use of resuscitative fluids for plasma volume expansion in hemodynamic resuscitation.
  • Identify the characteristics of commercially available albumin solutions and the considerations for albumin administration.
  • Review the literature regarding the use of albumin as a resuscitative fluid.

Continuing Education Disclosure Statement

Successful Completion

Learners must attend/view/read the entire activity and complete the associated evaluation to be awarded the contact hours or CERP. No partial credit will be awarded.

Disclosure

This activity has been reviewed by the Nurse Planner. It has been determined that the material presented here shows no bias. No conflicts of interest have been identified for any individual with the ability to influence the content of this activity. Accreditation refers to recognition of continuing education only and does not imply AACN or ANCC approval or endorsement of any commercial products discussed or displayed in conjunction with this educational activity.

Accreditation

The American Association of Critical-Care Nurses (AACN) is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's (ANCC's) Commission on Accreditation, ANCC Provider Number 0012. AACN has been approved as a provider of continuing education in nursing by the California State Board of Nursing (CBRN), California Provider number CEP 1036. This activity is approved for 1.00 contact hours.

AACN programming meets the standards for most states that require mandatory continuing education contact hours for license and/or certification renewal. AACN recommends consulting with your state board of nursing or credentialing organization before submitting CE to fulfill continuing education requirements.