Human Albumin Solution (Surgical — Volume/Oncotic)

How it works

Albumin is the major plasma protein and accounts for most of the intravascular oncotic (colloid osmotic) pressure, so an infusion draws and retains fluid within the vascular compartment to support circulating volume.

Prescribing in practice

• Infuse with caution in patients at risk of circulatory overload (cardiac failure, renal impairment) as the oncotic load can precipitate pulmonary oedema; stop the infusion at the first sign of hypervolaemia.
• Choose concentration by clinical aim — iso-oncotic solution for volume replacement, concentrated solution where fluid restriction or marked hypoalbuminaemia applies — and give through a standard infusion set without an additional filter.
• It is a blood-derived product: check the solution is clear before use, do not mix with packed red cells, protein hydrolysates or alcohol-containing solutions, and discard any unused portion of an opened container.

Monitoring

Monitor blood pressure, heart rate, urine output and signs of fluid overload during and after infusion, with haematocrit and electrolytes as guided by the clinical picture.

Counselling the patient

• Explain this is a human plasma-derived product given by drip to support blood volume during or after your operation.
• Tell staff at once if you feel breathless, flushed or develop a rash during the infusion.

Evidence & guidelines

Albumin is an established perioperative colloid; UK practice and the SPC reserve it for defined volume/oncotic indications rather than routine fluid resuscitation, where crystalloids are generally first-line.