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Debate: Albumin administration should not be avoided

Published by National Institutes of Health | U.S. Department of Health & Human Services | Catalog Last Checked: September 07, 2025 at 12:39 PM | Dataset Last Updated: September 06, 2025
The recent Cochrane report on albumin administration is analysed and criticised on the grounds of clinical methodology, content and interpretation. Although it is naïve and illogical to treat hypoalbuminaemia with albumin infusions, a more balanced view on the use of albumin for resuscitation in acute hypovolaemia is necessary. Once the acute phase of critical illness is past, interstitial volume is often expanded causing oedema, with a low plasma volume. We argue for the use of salt-poor albumin solutions in this situation and conclude that, on current evidence, the assertion that albumin should be avoided in all situations is irrational and untenable.

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