Use and misuse of albumin infusions in neonatal care

During the neonatal period, albumin infusions are administered in response to a variety of clinical scenarios. Review of currently available literature, however, demonstrates that crystalloid rather than colloid infusions should be used both to treat hypovolaemic hypotension and as the replacement fluid in a dilutional exchange. The role of an albumin infusion in "treating" metabolic acidosis needs further evaluation, but the practice of giving albumin to correct "asymptomatic" hypoalbuminaemia or at resuscitation should be discouraged.

The neonatologist would be well advised, when reaching for an albumin infusion, to reflect that there may be a safer, certainly cheaper and equally effective alternative.