Bilirubin is a breakdown product of heme and elevated levels may cause jaundice and neurotoxicity. Phototherapy is prescribed for these conditions. Free bilirubin is toxic while its conjugates with albumin is non toxic. Can albumin injection be a potential therapy?
Experimental study for this can be design but albumin has been used as treatment to prevent dehydration in several trials in case of burns and trauma not in case of higher bilirubin but we have to also think regarding altered level of Zinc , Retinol and osmolarity of the whole body fluid. Furtermore its fruitfulness in liver disease is well known....
There is probably no place for albumin in a standard treatment protocol for neonatal jaundice. However, as suggested by other respondents as well as the references provided by dr.Bloks, there may be a place for i.v. albumin in exceptional circumstances. Thus, in an infant acutely threatened by kernicterus, particularly if that infant has low S-albumin values, it is conceivable that i.v. albumin could be a useful adjunct to shift the equlibrium from tissues (including brain) to the vascular compartment in the interim before blood for an exchange transfusion becomes available. Please note that high intensity phototherapy shoul always be provided emergently in all such cases, and I would certainly give IVIG if there is any evidence of blood group incompatibility.
Albumin should not be used as a routine in the management of NNJ. We do use it in some cases when serum bilirubin is high in exchange level especially if albumin is low.
of course intensive phototherapy will be the main part of the treatment. Also to avoid exchange
we can give IVIG .
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