Human albumin and colloid fluid replacement: their use in general surgery

This review considers the pharmacology and indications for use of human albumin and synthetic colloids in general and transplantation surgery. The selection of a particular agent should be based on sound knowledge of their pharmacokinetic and pharmadynamic properties together with some consideration of cost. For correction of hypovolemia, human serum albumin solutions can adequately be replaced by present day colloids such as hydroxyethyl starch solutions. The duration of their effect in the intravascular space and their properties for plasma volume substitution or expansion are the main factors that will influence their selection. Albumin solutions, however, remain useful for treatment of all acute situations of hypovolemia accompanied by hypoalbuminemia during and after surgery.