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Albumin administration in a CHF patient - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Congenital Heart Disease
Answered by

General & Family Physician
Practicing since : 2009
Answered : 536 Questions
User :   Can IV albumin cause adverse reactions in person with congestive heart failure, anemia, and kidney disease? Literature says it is contraindicated in those conditions but I cannot find out why.
Doctor :   hi
User :   hi
Doctor :   ok
Doctor :   IV albumin is a a protein concentrate
User :   yes
Doctor :   this when given in normal individuals , causes increase in blood volume, due to retention of more fluids in the blood
Doctor :   when this blood volume increeases the effect is beared by the kidney, heart and they change their function accordingly
Doctor :   But in a patient with chronic renal failure or Congestive heart failure, and anemia, the body is already in volume overload
Doctor :   and the kidneys and heart are very weak and not able to cotrol the system adequately
User :   My mom has chf (with fluid overload due to IV fluids) she ended up gaining 80 lbs. Normal weight is 100 lbs. She was given IV albumin and had back pain. She now has acute renal injury and has been on dialysis for first time today.
Doctor :   so use of albumin in such conditions , willl cause more trouble and complications
User :   what do I do? I have voiced my concerns but they just keep giving her albumin...
Doctor :   ok
Doctor :   you will have to discuss this with your dcoctors treating your mother
Doctor :   and also ask the casuse for them to use albumin in such cases
User :   they said it is to pull the fluid out of the places it is not supposed to be (just under her skin) and into the blood stream... I hope it works out. Thanks.
Doctor :   SDG
User :   I sure hope so.
Doctor :   presence of excess fluids in the tissues means the oncotic pressur in the blood is less
Doctor :   using albumin, but in a lower dosage can be useful
Doctor :   as this can increase the oncotic pressure in the blood, and pull water into the circulation
Doctor :   and then using diuretics, it can be removed
User :   what dosage would you say is right?
Doctor :   but if ex
Doctor :   usuallly a albumin infusion can be given over 30-45 minutes normally
Doctor :   in this case they can take 1-2 hrs
Doctor :   it may vary and they can use the clinical skill to determine that
User :   I see. Okay.
Doctor :   so , excess pressure due to fluids in the tissue can cause tissue damage
Doctor :   to prevent this ur docs have used albumin
Doctor :   its a differnt issue
Doctor :   i hope i ahve cleared any of ur doubts
User :   She has more than one issue going on. If I need to ask another question, I'll log back in. You have helped me. Thanks.
Doctor :   sure
Doctor :   you r welcome
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