Plasbumin-20, 20% 50 ml

Pharmacotherapeutic group: plasma substitute.

ATX code B05AA01

Pharmacological properties: Plasbumin 20 is a 20% sterile aqueous albumin solution and is produced from human plasma using a cold ethanol fractionation process.

Plazbumin 20 is a hyperoncotic protein solution and, when administered intravenously, increases circulating plasma volume by diffusing fluid from the interstitial space (provided that the volume of the latter is within normal or increased). Every 50 ml of Plasbumin 20 when administered intravenously to the patient provides an increase in oncotic pressure equivalent to about 200 ml of citrate plasma. When injected into the vascular stream, 50 ml of Plasbumin 20 draws approximately 125 ml of fluid from the intercellular space into the circulatory system within 15 minutes, thereby increasing circulating blood volume and reducing hematocrit and whole blood viscosity.

Indications

Active ingredient

Composition

How to take, the dosage

Doses and mode of administration are set individually, taking into account the nature of the disease and the age of the patient. The average daily dose of Plazbumin 20 for adults is 50 to 75 g; for children – 25 g. The total drug dose should not exceed the normal albumin level (about 2 g/kg body weight) in the absence of active bleeding.

Plasbumin 20 should only be administered intravenously!

Therapy of burns
Generally, Plazbumin 20 is recommended to maintain colloidal-osmotic plasma pressure 24 hours after a thermal injury (large volumes of saline solutions are transfused in the first 24 hours to restore the reduced volume of extracellular fluid). It is recommended to maintain plasma albumin concentration at 20-30 g/l with plasma oncotic pressure equal to 20 mm Hg (equivalent to total protein concentration of 52 g/l). The duration of therapy is determined by the loss of protein from the burned areas and in the urine.

Hypoproteinemia with or without tissue edema
The usual daily dose of Plasbumin 20 for adults is 50 to 75 g; for children, 25 g. Patients with severe hypoproteinemia who continue to lose albumin may require larger amounts. Since patients with hypoproteinemia usually have normal blood volume, the infusion rate of Plazbumin 20 should not exceed 2 ml/min, since a faster infusion may cause circulatory disorders and pulmonary edema.

Adult acute respiratory distress syndrome (ARDS)
If patients have clinical signs indicating both hypoproteinemia and hypervolemia, it is appropriate to administer Plazbumin 20 in the above doses together with a diuretic.

Aortic/coronary artery bypass grafting
It is common practice to administer hemodilution therapy (to fill the AIC during surgery) using albumin and crystalloids until the patient has a hematocrit level of 20% and a plasma albumin concentration of 25 g/L.

Hemolytic disease in newborns
Plasbumin 20 is administered approximately one hour before the exchange transfusion procedure at a dose of 1 g/kg body weight. Caution should be exercised in the presence of initial hypervolemia in children.

Perfusion of red blood cell mass
Plasbumin 20 is usually added to an isotonic suspension of washed red blood cells at a dose of 25 g albumin per 1 liter of red blood cell mass just before transfusion of thawed washed red blood cells. If a patient has concomitant hypoproteinemia or severe liver damage, the dose of Plazbumin 20 may be increased.

Acute nephritis
To increase the effectiveness of therapy with cyclophosphan or steroids, as well as in case of edema syndrome increase during steroid treatment a combined daily administration of 100 ml of Plazbumin 20 and loop diuretics for 7-10 days with monitoring of diuresis and potassium concentration in plasma is possible.

Hemodialysis
Administration of Plasbumin 20 is indicated when shock or hypotension develops in patients with chronic renal failure during standard hemodialysis. The standard dose is 100 ml of Plasbumin 20. Volume overload, often observed in such patients, should be avoided (this is why they cannot tolerate the administration of large volumes of saline solutions).

Interaction

Special Instructions

Each vial should be carefully inspected before use. Muddy or frozen solutions as well as partially used vials should be destroyed.

Plazbumin 20 may be used either undiluted or in combination with 0.9% sodium chloride solution or 5% glucose (dextrose) solution. If sodium restriction is necessary, Plazbumin 20 should be used only undiluted or with a carbohydrate solution containing no sodium chloride, such as 5% glucose (dextrose) solution.

Only 0.9% sodium chloride solution or 5% glucose solution may be used as a solvent for Plazbumin 20: administration of Plazbumin 20 or any other hyperoncotic protein solutions in combination with water for injection in large amounts may lead to hemolysis and acute renal failure.

Hemodynamic parameters of the patient should be monitored during administration of Plasbumin 20, observing the usual precautions to prevent hypervolemia.

If there is concomitant dehydration, albumin transfusion should be accompanied by administration of saline solutions.

In acute massive blood loss, administration of albumin may be supplemented by transfusion of red blood cell mass or whole blood.

The rapid increase in blood pressure that follows a transfusion of Plasbumin 20 may be accompanied by increased bleeding from vessels that did not bleed at lower blood pressures (physician control!).

Influence on driving ability:

There has been no effect of Plasbumin 20 on the ability to drive or operate machinery.

Synopsis

Contraindications

– hypersensitivity;

– hypervolemia;

– pulmonary edema.

With caution use:

– In thrombosis;

– Heart failure (danger of exacerbation!);

– renal insufficiency;

– severe anemia;

– arterial hypertension;

– ongoing internal bleeding.

Side effects

Overdose

Pregnancy use