Use of albumin

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.6997.129a (Published 08 July 1995) Cite this as: BMJ 1995;311:129
  1. Nigel G B Richardson,
  2. Denise F O'Shaughnessy
  1. Surgical registrar Consultant haematologist St Peter's Hospital, Chertsey, Surrey KT16 0PZ

    EDITOR,--Neil Soni concludes that the theoretical advantages of albumin as a colloid replacement fluid are not translated into overt clinical benefits. Quite apart from this, albumin is extremely expensive: in our hospital 100 ml of 20% solution and 500 ml of 5% solution each cost £30.

    With the imminent introduction of invoicing of individual clinical departments for blood products used, we audited the use of albumin, among other products, over 12 months. The four main users were gastroenterology (22.5 litres), general medicine (29 litres), paediatrics (109 litres), and general surgery (287 litres). In general surgery all the albumin was used for patients in the intensive care unit, which now holds a separate budget from that of the department of surgery. The indications for using human albumin solution, at a total cost during the year of £31680, were rarely based on published guidelines such as those in ABC of Transfusion.2

    We believe that the only indications for using albumin in our hospital are the resuscitation of neonates and the treatment of oedema resistant to diuretics. By introducing a system whereby albumin solutions will be released only after the completion of a form listing the indications for their use, we hope to cut the amount of albumin used by at least half; this would translate into a minimum saving of £15840.


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