Plasma disappearance rate of albumin when infused as a 20% solution

BACKGROUND: The transcapillary leakage of albumin is increased by inflammation and major surgery, but whether exogenous albumin also disappears faster is unclear. METHODS: An intravenous infusion of 3 mL/kg of 20% albumin was given over 30 min to 70 subjects consisting of 15 healthy volunteers, 15 post-burn patients, 15 patients who underwent surgery with minor bleeding, 10 who underwent surgery with major bleeding (mean, 1.1 L) and 15 postoperative patients. Blood Hb and plasma albumin were measured on 15 occasions over 5 h. The rate of albumin disappearance from the plasma was quantitated with population kinetic methodology and reported as the half-life (T(1/2)). RESULTS: No differences were observed for T(1/2) between volunteers, post-burn patients, patients who underwent surgery with minor bleeding and postoperative patients. The T(1/2) averaged 16.2 h, which corresponds to 3.8% of the amount infused per h. Two groups showed plasma concentrations of C-reactive protein of approximately 60 mg/L and still had a similarly long T(1/2) for albumin. By contrast, patients undergoing surgery associated with major hemorrhage had a shorter T(1/2), corresponding to 15% of the infused albumin per h. In addition, our analyses show that the T(1/2) differ greatly depending on whether the calculations consider plasma volume changes and blood losses. CONCLUSION: The disappearance rate of the albumin in 20% preparations was low in volunteers, in patients with moderately severe inflammation, and in postoperative patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-022-03979-1.