Current non-surgical usage of albumin preparations in clinic divisions

New guidelines for the clinical use of blood preparations, intended to promote a 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 non-surgical use of albumin (Alb) preparations in each clinic division and to design a plan to promote the rational use of these products at Yamaguchi University Hospital. Of the patients administered Alb preparations in the clinic divisions of our hospital over the six-month period from January 1 to June 30, 1999, 454 were selected based on prescription records of plasma component preparations. Most of the patients were 60 years of age or older (61.7%) and from the surgery division (65.2%). The total amount of Alb administered to the patients was 52.9 kg. Those patients whose serum Alb concentration was less than 2.5 g/dl before and more than 3.5 g/dl after the administration numbered 125 and 122, respectively. The total amount of Alb overdosed to the patients, whose Alb concentration after administration of the preparations was more than 2.5 g/dl, was 17.7 kg (33.5% of the administered amount). The overdosed patients belonged mainly to the surgery division. These results indicate that it is possible to cut back on Alb by reconsidering the criteria for its administration, and that we need to promote more intensively the need to monitor the level and predict the effect of Alb in surgical divisions.