Mar 15, 2017 · 1. Albumin 25%, 25 gm IV BID x2 doses (or 12.5 gm IV q6h x4 doses) may be used in combination with diuretics. 2. Monitor urine output and volume status and assess daily. If successful at achieving diuresis, may reorder albumin until serum albumin is >3 gm/dL but must be renewed each day after daily assessment. Postoperative Lung Transplant
Albumin for Patients with SBP or Large-Volume Paracentesis
It is also reasonable to consider albumin infusion in patients undergoing large volume paracentesis (more than 5 liters of ascitic fluid removed), though the evidence in support of this is much less compelling.
Standardizing Use of Albumin in Large Volume Paracentesis
Albumin infusion is indicated after Large volume paracentesis (LVP) when >5L is removed, to prevent Paracentesis-Induced Circulatory Dysfunction (PICD).At our hospital there is significant variability in grams and concentration of albumin ordered after LVP, resulting in high costs.
Use of Intravenous Albumin - CHEST
Mar 4, 2024 · Recommendation 10: In patients with cirrhosis and ascites undergoing large-volume paracentesis (> 5 L), intravenous albumin is suggested to prevent paracentesis-induced circulatory dysfunction (Conditional Recommendation, Very Low Certainty of Evidence of Effect).
Standardizing the Use of Albumin in Large Volume Paracentesis
Background: Albumin after large volume paracentesis (LVP) reduces paracentesis-induced circulatory dysfunction (PICD). The most efficacious dose of albumin for LVP is unclear. Objective: To evaluate the impact of implementing a standardized LVP order set on albumin utilization and patient outcomes.
Paracentesis without albumin replacement leads to a fall in pulmonary capillary wedge pressure, maximal at 6 hours, and can result in circulatory and renal dysfunction.
Appropriate Use of Albumin: 1. Post paracentesis if > 4L of ascites removed. May use 6-8g of albumin for each liter removed4 2. Therapeutic plasmapheresis : Albumin is appropriate if exchange is > 20ml/kg in one session or repeated sessions 3. Spontaneous bacterial peritonitis : Recommended albumin administration of 25% in the
Based on our review of the evidence we believe that albumin transfused at a rate of 6-8 g/L removed should be strongly considered for therapeutic paracentesis of ANY volume in patients with risk for PICD (see our document on PICD for specific risks), AKI, or risk for AKI.
Albumin infusion in patients undergoing large-volume paracentesis…
Albumin infusion reduces the incidence of postparacentesis circulatory dysfunction among patients with cirrhosis and tense ascites, as compared with no treatment. Treatment alternatives to albumin, such as artificial colloids and vasoconstrictors, have been widely investigated.
10. Paracentesis | Hospital Handbook - UCSF Hospitalist Handbook
Post-paracentesis albumin is not necessary for removal of <5L. For ≥5L removed, albumin replacement can be given. The AASLD Class IIA recommendation is 6-8 grams of albumin for every liter removed (~1 bottle of 50cc of 25% IV albumin per 2 liters of ascites).