Critical Matters Albumin in Critical Care
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Sep 30, 2024 D. Jeannie Callum, Director of Transfusion Medicine and Professor at Queens University, dives deep into the complexities of intravenous albumin use in critical care. She discusses emerging evidence that questions its safety and efficacy, alongside challenges of inconsistent practices worldwide. Callum also addresses the financial implications and potential risks associated with albumin, especially in vulnerable patient groups. The conversation underlines the necessity of solid evidence and patient inclusion in treatment guidelines for better healthcare outcomes.
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Risks Beyond Benefits of Albumin
- Albumin use in critical care carries risks including heart failure, increased bleeding, and thrombotic complications.
- Donor harm and healthcare system costs also warrant caution in albumin prescription.
Global Variability in Albumin Use
- Albumin use varies greatly worldwide, with the US being the highest per capita user.
- This variability reflects medical culture rather than differing patient needs or benefits.
Albumin is Blood Product, Not Drug
- Albumin is a blood product, not a pharmaceutical, derived from pooled plasma donations.
- In critically ill patients, albumin's intravascular half-life is short due to leakage caused by endothelial dysfunction.