5% albumin

GregRN · Apr 16, 2007

Two issues here: theory, and practice. We know that albumin will come in two concentrations: 5% and 25%. The 25% will come in a 50ml bottle and the 5% concentration will come in a (surprise!) 250ml bottle. To answer your question, yes, you can dilute 25% albumin with 200ml of normal saline or 5% dextrose to make it 5% albumin. Which one you would use to dilute (NS or D5) would depend on the current clinical picture of that particular patient.

Now, in practice, how would you do this? Albumin is very sticky but doesn't stick to the bottle, thereby allowing the entire contents to be used on the patient. That's why the typical bags we are used to aren't used for delivering albumin. Now, you have the 50ml bottle of 25% albumin and you want to dilute it. You can't add 200ml to the 50ml bottle; you would have to take it out of the bottle, put it in a larger container, mix it with 200ml of NS or D5 then set drip it into the patient. What container would you put it in? You wouldn't want to use a bag: much of the albumin would stick to the bag, not giving the patient the total benefit you hoped. Another bottle? Where would this bottle come from? Would it come from an already used bottle of 5% albumin??

In a pinch, if nothing else was available, I would put it in a bag and give the patient SOME benefit from its use. Or, I might use 25% albumin, "Y" it on a separate pump with 200ml of NS or D5 and set both of them to expire at the same time. So, in theory, yes, you can dilute 25% albumin. In practice, it can get a bit tricky.

RedCell · Apr 16, 2007

Pretty slick dude, but what if I wanted to dilute my albumin down to 3.14%? Just kidding.

GregRN · Apr 16, 2007

Pretty slick dude, but what if I wanted to dilute my albumin down to 3.14%? Just kidding.

Easy as "pi".

Sorry. Horrible joke.

RazorbackRN, BSN, RN · Apr 16, 2007

Two issues here: theory, and practice. We know that albumin will come in two concentrations: 5% and 25%. The 25% will come in a 50ml bottle and the 5% concentration will come in a (surprise!) 250ml bottle. To answer your question, yes, you can dilute 25% albumin with 200ml of normal saline or 5% dextrose to make it 5% albumin. Which one you would use to dilute (NS or D5) would depend on the current clinical picture of that particular patient.
Now, in practice, how would you do this? Albumin is very sticky but doesn't stick to the bottle, thereby allowing the entire contents to be used on the patient. That's why the typical bags we are used to aren't used for delivering albumin. Now, you have the 50ml bottle of 25% albumin and you want to dilute it. You can't add 200ml to the 50ml bottle; you would have to take it out of the bottle, put it in a larger container, mix it with 200ml of NS or D5 then set drip it into the patient. What container would you put it in? You wouldn't want to use a bag: much of the albumin would stick to the bag, not giving the patient the total benefit you hoped. Another bottle? Where would this bottle come from? Would it come from an already used bottle of 5% albumin??
In a pinch, if nothing else was available, I would put it in a bag and give the patient SOME benefit from its use. Or, I might use 25% albumin, "Y" it on a separate pump with 200ml of NS or D5 and set both of them to expire at the same time. So, in theory, yes, you can dilute 25% albumin. In practice, it can get a bit tricky.

Or you could use a buretrol tubing system and put the NS in the buretrol. By the way, we use .25 albumin on nearly all of our pt's (I work in a burn unit). Ours is supplied in 100ml bags. It is a harder plastic bag, that doesn't required a vented spike. We used bottles up until a couple of months ago, but those have been phased out in our facility.

Susan9608 · Apr 16, 2007

So ... since I work in pediatrics and tend to need smaller doses ... if I was going to mix the albumin in a 60 mL syringe, would I be correct that if I took 10 mL of the 25% albumin and mixed it with 40 mL of normal saline that would give me 50 mL of 5% albumin?

mshultz · Apr 17, 2007

So ... since I work in pediatrics and tend to need smaller doses ... if I was going to mix the albumin in a 60 mL syringe, would I be correct that if I took 10 mL of the 25% albumin and mixed it with 40 mL of normal saline that would give me 50 mL of 5% albumin?

The formula for this type of calculation is N1 x V1 = N2 x V2 (Normality of first solution times volume of first solution equals Normality of second solution times volume of second solution). We can substitute percentage for Normality so:

.25 x 10ml = .05 x 50ml

2.5 = 2.5

So, Yes this is correct.

mshultz · Apr 17, 2007

Pretty slick dude, but what if I wanted to dilute my albumin down to 3.14%? Just kidding.

Starting with 50ml of 25% albumin:

N1 x V1 = N2 x V2

.25 x 50ml = .0314 x V2

12.5 = .0314 x V2

V2 = 12.5 / .0314

V2 = 398ml

398ml - 50ml = 348ml

348ml of normal saline needs to be added to the 50ml of 25% albumin, giving you 398ml of 3.14% albumin. Let's check this answer by plugging the numbers back into the original formula:

.25 x 50ml = .0314 x 398ml

12.5 = 12.5 (ignoring rounding errors)

mshultz · Apr 17, 2007

Easy as "pi".
Sorry. Horrible joke.

I like your sense of humor!

GregRN · Apr 17, 2007

I like your sense of humor!

Don't encourage me. I was going to make the last sentence in my original post on this thread "I practice, it can get a bit sticky" but decided against it. Coupled with my "pi" reference, it likely would have gotten me banned from the site. And for good reason.

RunningWithScissors · Apr 17, 2007

I hope this is all just theoretical....there is NO WAY any nurse should be messing around with albumin concentrations, esp. in a pedes unit!!!

Let the pharmcay supply the correct concentration......please!!!!