The use of albumin preparations during surgery

New guidelines for the clinical use of blood preparations intended to promote more rational use were issued by the Japanese Ministry of Health and Welfare in June 1999. The purpose of this article is to clarify the current situation in the use of albumin (Alb) preparations during surgery and to design a plan to promote the rational use of these products at Yamaguchi University Hospital. Of the patients administered Alb preparations during surgery in our hospital over the 6 month period from January 1 to June 30, 1999, 158 were selected based on prescription records of plasma component preparations. Most of the patients (63%) were 60 years old or over. The total amount of Alb administered to the patients was 6150 g. Those patients, whose postoperative serum Alb concentration was lower than 3, 3 to 3.5, 3.5 to 4, and more than 4 g/dl, numbered 60, 45, 21, and 23, respectively. The total amount of Alb overdosed to the patients, whose postoperative Alb concentration was more than 3 g/dl, was 2282 g (37% of the administered Alb). The overdosed patients mainly belonged to the Cardiovascular Surgery Division and were treated with a pump-oxygenator during surgery. Three bottles (37.5 g) of concentrated Alb had usually been used to prime the perfusate. These results indicate that it is possible to cut back on Alb by reconsidering the criteria for its administration.