Albumin: Biochemical properties and therapeutic potential

Human serum albumin (HSA) has many physiological and biochemical properties that render it relevant to many aspects of the disordered vascular and cellular functions that characterize the critically ill; particularly those afflicted by the systemic inflammatory response syndrome-sepsis, severe sepsis, and septic shock. The use of albumin as a routine volume expanding agent in the intensive care setting cannot be justified in terms of a mortality or morbidity advantage over crystalloid solutions. However, albumin may be beneficial in specific clinical circumstances, such as in patients with cirrhosis complicated by SBP, and its potential to modulate the inflammatory response is, we suggest, worthy of further exploration. Copyright © 2005 by the American Association for the Study of Liver Diseases.