The Role of Albumin in the Resuscitation of Hypotensive Patients

Abstract

Purpose of Review Albumin is a colloid used in fluid resuscitation, with intrinsic physiologic properties that make it ideal to use for certain hypotensive patients. Despite this, its indications for use in this context are the source of much debate. This review aims to provide an overview of the history of albumin, explain its rise and fall in popularity, and identify situations where use of albumin may be beneficial over other forms of fluid resuscitation. Recent Findings The use of albumin dropped significantly in 1998 after a review article was published suggesting that it was harmful to use in critically ill patients. It was not until 2004 and 2014 when the first large-scale randomized control trials were performed demonstrating that albumin administration in certain hypotensive critically ill patients was associated with decreased morbidity and mortality. Summary Compared to other fluids, albumin appears to be safe for most patient populations. Choice of resuscitation fluid is partly provider dependent; however, there is an increasing body of evidence supporting albumin use associated with improved patient outcomes.