In my hospital practice, I have a lot of patients with various acute infections of different severity, and most of them with severe infections and sepsis have hypoalbuminemia of various degrees, as we all know, as a part of the acute-phase response. My question: Should we treat this hypoalbuminemia with albumin substitution or not, and if yes, what would be the albumin serum levels when we should start treatment, and what would be dose and percentage of albumin solution for substitution? I would like some references also.
There is no evidence supporting i.v. albumin substitution in case of sepsis. As this treatment must be seen as an intervention that might have adverse effects (it is immunogenic material) I would absolutely not recommend it based on present data. One has to take into account that hypoalbuminemia is probably only an epiphenomenon and not something that worsens the clinical course in these situations.
In severe sepsis there's development of multiorgan dysfunction syndrome..and if liver is involved in this process..the synthetic function of liver is compromised or may be there's excessive loss from renal system. S. Albumin levels less than 1.5 mg/dl with remarkable features of fluid extravasation in pleural and peritoneal cavity.. should be treated with albumin infusion. Dose: 0.5-1 gm/kg of 20% albumin solution.Contradiction to i.v. infusion is acute renal failure..
This question is debated for decades and you find plenty of literature for both standpoints. In my opinion you should treat a severe hypoalbuminemia (
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