Albumin in Critical Care

The podcast explores the appropriate use of intravenous albumin in critical care, a topic often utilized but potentially misused in intensive care units. Dr. Jeannie Callum, Director of Transfusion Medicine at Queen's University, highlights concerns about patient harm, including transfusion-associated circulatory overload and increased bleeding risks, based on modern studies. She also addresses the cost, environmental impact, and potential harm to plasma donors. The discussion covers the variability in albumin usage across different countries, the distinction of albumin as a blood product, and its limited effectiveness in maintaining intravascular volume in critically ill patients. Specific patient categories are examined, including those with thermal injuries, ARDS, renal replacement therapy, cardiovascular surgery, and end-stage liver disease, with recommendations against using albumin as a first-line volume replacement in most critically ill adults.