低蛋白血症、休克、燒傷。適用於血量不足而需使用膠體溶液來恢復和維持血液循環量的病患

Blood Product Derivative; Plasma Volume Expander, Colloid

分佈

在正常的情況下，總共可交換的白蛋白總量約是4-5克/每公斤的體重，其中40 - 45％存在血管內，55％-60％在血管外的空間。增加毛細血管滲透性會改變白蛋白的動力學。白蛋白分佈異常可能發生在病理性情況下，如嚴重燒傷後和敗血性休克時。排除在正常情況下，白蛋白的平均半衰期約19天。合成和分解之間的平衡通常經由一個回饋機制達成。

排除

排除主要經由細胞內的溶小體蛋白白。 在健康的受試者中，在輸注後的前2小時內，離開血管內室的輸注白蛋白少於10％。個體間的差異對血漿容量影響相當的大。某些患者的血漿容量呈現增高的狀態達數小時。然而，在危重病患者中，白蛋白會以一個不可預測的速度大量地漏出血管系統。

Half-life: 15 to 20 days

1. hypersensitivity to albumin or any component of the formulation
2. severe anemia or cardiac failure with normal or increased intravascular volume
3. patients at risk of volume overload

C, should be given to a pregnant woman only if clearly needed.

Endogenous albumin is present in breast milk.
According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and benefits of treatment to the mother.

Cardiovascular: Flushing, heart failure, hypotension, tachycardia

Dermatologic : Pruritus, skin rash, urticaria

Gastrointestinal : Nausea, vomiting

Nervous system: Chills, rigors

Respiratory : Bronchospasm, dyspnea, pulmonary edema

Miscellaneous : Fever

Cirrhotic ascites, therapeutic large volume paracentesis (adjunctive agent):

- 25% albumin: IV: 6 to 8 g for every liter removed or 50 g total for paracentesis >5 L.
- Note: Administer at the time of or soon after the procedure to avoid paracentesis complications (eg, hypovolemia, hyponatremia, kidney impairment).

Hepatorenal syndrome-acute kidney injury (hepatorenal syndrome type 1), treatment (adjunctive agent) (off-label use):

- Note: Used before or in combination with norepinephrine, terlipressin, or midodrine plus octreotide.
- 25% albumin: IV: Initial: 1 g/kg daily for 2 days (maximum: 100 g/day), followed by 20 to 50 g daily until clinical outcome is achieved.

Ovarian hyperstimulation syndrome, severe (treatment) (alternative agent):

- Note: In general, albumin is an alternative to IV crystalloid therapy in patients who are critically ill and volume depleted; current evidence indicated no added benefit for the wider population of critically ill patients.
- 25% albumin: IV: 50 to 100 g over 4 hours; repeat at 4- to 12-hour intervals as needed.

Plasma exchange, therapeutic:

5% albumin: IV: Titrate dose to plasma volume removed during procedure.

Spontaneous bacterial peritonitis, treatment (off-label use):

- Note:
Some experts reserve for patients with existing kidney or severe hepatic impairment (eg, creatinine >1 mg/dL, BUN >30 mg/dL, or bilirubin >4 mg/dL).

- 25% albumin:
IV: Initial: 1.5 g/kg within 6 hours of diagnosis in combination with appropriate antimicrobial therapy, followed by 1 g/kg on day 3 ; a possible alternative dose is 1 g/kg once daily for 2 days but it is not well studied . While the maximum albumin dose varies in clinical practice, some suggest not exceeding 100 g per dose.

Ascites with hypoalbuminemia:
Limited data available: Infants, Children, and Adolescents: 25% albumin: IV: 0.5 to 1 g/kg/dose over 2 to 3 hours; may repeat up to 3 times per day until albumin is >2.5 g/dL; maximum dose: 25 g/dose.

Hypovolemia, plasma volume expansion, including hypovolemic shock:
Infants, Children, and Adolescents: 5% albumin: IV: 0.5 to 1 g/kg/dose (10 to 20 mL/kg/dose) over 5 to 10 minutes.May repeat after 15 to 30 minutes if response is not adequate.

Large volume paracentesis:
Limited data available: Infants, Children, and Adolescents: 5% or 25% albumin: IV: 0.5 to 1 g/kg over 1 to 2 hours after paracentesis.

Nephrotic syndrome edema, refractory:
Infants, Children, and Adolescents: 25% albumin: IV: 0.5 to 1 g/kg/dose over 30 to 60 minutes followed by diuretic therapy.

No dosage adjustment necessary for any degree of kidney impairment

There are no dosage adjustments provided in the manufacturer's labeling; use with caution.

should be stored at a temperature not exceeding 30°C (86°F).

本產品可直接施打，也可以先用等滲壓溶液進行稀釋（如5％葡萄糖或0.9％氯化鈉）。白蛋白溶液不能以注射用水稀釋，因其可能會導致患者溶血現象。

輸注速率應根據個人的情況和徵兆調整，但是一般應不超過1-2毫升/分鐘。

不相容性：AlbuRx 25不能與其他藥物混合，包括全血及紅血球濃縮液。