Albumin and Urine Output

stsdoc · Sep 4, 2004

I was wondering if anyone can share w/ me how/why..etc..albumin effects urine output.
A post op AAA repair patient of mine w/ no other significant medical hx. Her post op urine output was low, so I infused albumin. I don't quite understand/remember how that works.
Thanks!!!!!!!!!!!! :kiss

Albumin increases the capillary oncotic pressure, which sucks fluid from the tissues into the blood. The fluid is filtered through the kidney and peed out.

Anniekins · Sep 4, 2004

Why would this be used as oppose to a diuretic or fluids (depending on the patients fluid status)?? :uhoh3:

Gompers, BSN, RN · Sep 4, 2004

Why would this be used as oppose to a diuretic or fluids (depending on the patients fluid status)??

If the patient is third-spacing all the fluid you give her and has a low urine output, then giving her more fluid is just going to overload her and will cause more fluid to third-space. After an AAA repair, I can imagine that the body must be in at least a little bit of a hemodynamic shock state, causing this third spacing. Giving a diuretic won't draw the fluid out of the tissues nearly as well as albumin would, for the reasons the previous poster stated. You need to get that fluid sucked out of the tissues and into the vessels in order to increase urine output. We sometimes give albumin followed by lasix, so that there isn't a drastic fluid shift - from low to high blood volume - but if the patient continues to be hemodynamically "dry" then we just give albumin and no lasix, in an attempt to build up that blood volume and give the kidneys something to work with.

This is in NICU, but I'd imagine it works similarly in adults?

Anniekins · Sep 4, 2004

Thank you both VERY much! although brief, that REALLY helped me!!!!

Keep the responses comming!!!!!!!!!!

Anniekins :)