HUMAN ALBUMIN SOLUTIONS - AN AUDIT OF USE IN 3 MAJOR METROPOLITAN HOSPITALS

Objective: To evaluate the volume used and the indications for use of the human albumin solutions, stable plasma protein solution and normal serum albumin, in Victorian metropolitan teaching hospitals. Design: The Victorian Drug Usage Advisory Committee conducted a prospective audit by means of a questionnaire in three major Melbourne teaching hospitals over a three-month period. All bottles of the human albumin solutions issued were numbered and a questionnaire regarding indications for use was completed for each patient treated with either product. Outcome measures: The results were compared with the recommendations of the Australasian Society of Blood Transfusion to determine whether usage was appropriate, and the number of bottles used was analysed for each hospital and each major indication. Results: The survey was comprehensive (84% of the forms were returned) and demonstrated that these products are used for appropriate clinical categories, for example, hypovolaemia, hypoalbuminaemia, and not for inappropriate indications, such as nutritional support or wound healing. There was however a marked variation in the level of usage for a given indication between the three hospitals. Conclusions: This variation reflected a considerable difference in unit policy regarding the use of these products in preference to crystalloid or synthetic colloid solutions. The variation suggests the need for more specific guidelines for the use of these products in defined clinical settings.