The Use of Albumin in Clinical Practice

Serum Albumin: A Multifaced Enzyme

“…HSA is a valued biomarker of many diseases, (i.e., cancer, rheumatoid arthritis, ischemia, obesity, and diabetes) [ 19 , 20 , 21 , 22 ] and finds clinical application in the treatment of several pathologies including shock, trauma, hemorrhage, acute respiratory distress syndrome, hemodialysis, acute liver failure, chronic liver disease, and hypoalbuminemia [ 4 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. In the last years, it is emerging a novel role of HSA in human innate immunity [ 9 , 12 , 30 , 31 ].…”

Human albumin and starch administration in critically ill patients: A prospective randomized clinical trial

“…Moreover, hypoalbuminemia has been shown to be associated with an increased risk of mortality [3,4]. Consequently, intravenous administration of human albumin has become a common mode of therapy for several indications in severely ill patients [5][6][7]. The rationale for giving human albumin solutions rather than crystalline solutions is based upon Starling's principle, which in recent years has been questioned and modified [8].…”

POINT: Should Intravenous Albumin Be Used for Volume Resuscitation in Severe Sepsis/Septic Shock? Yes

“…4 Because of its macromolecular structure, human serum albumin is the main determinant of plasma oncotic pressure, playing a key role in regulating microvascular fluid dynamics. 5 Moreover, human serum albumin displays pivotal secondary functions, including ligand-binding capacity for several endogenous and exogenous molecules, antioxidant and anti-inflammatory properties, 6 and buffering capacities within the extracellular acid-base equilibrium. 7 All these properties may be potentially relevant during severe sepsis or septic shock (Table 1).…”