• Salim Abdelhamid, Rita Achermann, Alexa Hollinger, Madlaina Hauser, Maren Trutmann, Laura Gallacchi, and Martin Siegemund.
• Intensive Care Unit, Department of Acute Medicine, University Hospital Basel, Basel, Switzerland.
• Crit. Care Med. 2024 May 1; 52 (5): e234e244e234-e244.

ObjectivesThe aim of this study was to analyze the development of albumin administration in patients admitted to the adult ICU. In addition, we assessed the impact of albumin administration on serum hemoglobin concentration.DesignWe conducted a retrospective single-center study including all patients who were admitted to the ICU from January 2013 to December 2021 and stayed at least 24 hours.SettingThe study was conducted in an academic hospital (University Hospital Basel, Switzerland).PatientsA total of 20,927 admissions were included, of which 3748 received albumin at least once during their ICU stay. To analyze volume expansion, 2006 admissions met the inclusion criteria, namely at least two hemoglobin measurements within 12 hours, one albumin delivery, and experienced no bleeding, dialysis, or transfusions during this period.InterventionsNone.MeasurementsWe examined the hemoglobin levels before and after albumin administration and compared them with a matched control group to assess the amount and duration of volume expansion.Main ResultsFrom 2013 to 2021 the proportion of critically ill patients treated with albumin rose from 5.0% to 32.5%. An overproportioned increase in albumin use could be seen in surgical patients (4.7-47.2%) and in those receiving RBC transfusion (13.7-72.6%). In those patients receiving albumin, a significant drop in hemoglobin of around 5 g/L on average could be observed following treatment with albumin.ConclusionHemodilution was observable for at least 12 hours after albumin administration and may have caused a decrease in hemoglobin concentration of greater than 8 g/L when isooncotic albumin solution (5%, 25 g in 500 mL) was administered. This makes albumin, especially in its isooncotic form, an ideal colloid to achieve long-lasting volume expansion. However, RBC transfusions may increase under albumin therapy, as transfusion thresholds may be undershot after albumin administration.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc.

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