Debate: Albumin administration should be avoided in the critically ill

The benefit of albumin administration in the critically ill patient is unpr oven. Epidemiological evidence suggests that there is an increase in death among patients with burns, hypoalbuminaemia, and hypotension treated with h uman albumin solution (HAS). In critical illness, hypoalbuminaemia is a res ult of transcapillary leak, decreased synthesis, large volume body fluid lo sses and dilution caused by fluid resuscitation. When treating patients wit h hypoalbuminaemia, efforts must be centred around correction of the underl ying disorder rather than reversal of hypoalbuminaemia. Problems with using albumin arise because it is an expensive blood product, and can result in systemic changes that include cardiovascular, haematological, renal, pulmon ary, and immunological effects.