[Changing the use of albumin at the Oslo hospital]

An increasing demand for albumin in Oslo hospitals in the early 1990s instigated measures to reduce its use. During the autumn of 1993 a letter was sent to all doctors at Ullevål hospital informing them about the lack of documentation that albumin supplementation has a positive effect on outcome in critically ill with an albumin concentration of more than 20 g/l. In May 1994 the blood bank at Ullevål hospital stopped supplying 4% albumin solutions. A 20% reduction in use of albumin was observed after the letter of information, followed by a 50% reduction after the 4% solution was withdrawn. It is concluded that greater awareness of lack of information about the effects of albumin in critically ill patients has led to a more restrictive use of albumin. During the same period the use of polygeline increased, leading to the assumption that colloids other than albumin are being used for volume substitution.