[Clinical application of albumin: a closer look at indications]

Albumin infusions are given far from always on the correct indications, and often there are alternatives that are cheaper and equally suitable. In septic or hypovolaemic shock, crystalline fluids are cheaper and equally efficacious for volume therapy. It is only in sporadic patients with a nephrotic syndrome that colloidal solutions such as albumin are indicated in hypovolaemia. Albumin infusion has no place in the combating of oedema. In decompensated hepatic cirrhosis with ascites, it appears useful to combine paracentesis with albumin infusion, to prevent renal insufficiency and hyponatraemia, but other colloidal fluids are probably equally suitable. Combating hypoalbuminemia as such is not useful in seriously ill patients; it is the underlying disease that should be treated.