Evaluation and determining of the Pattern of the Human Albumin Utilization at Shahid Rahimi Hospital, Khorramabad, Iran

Vahid Rahimi, Fanak Fahimi, Javad Ghasemian Yadegari, Hadi Hayati Abbarik, Arian Karimi Rouzbahani, Zahra Heydari, Ali Kharazmkia

Abstract


Background: The World Health Organization (WHO) has supported many intervention strategies, including executive, educational, and monitoring proceedings to improve the evaluation of drug use and the drug management system. Since the resources are limited, it is essential to utilize existing resources properly. Serum albumin is the most abundant blood protein produced in the liver. Different forms of albumin are available in the market and employed to treat hypovolemia, Cirrhotic ascites, severe burns, septic shock, hyperstimulation syndrome, etc. Due to the high price of albumin and its importance for saving patient’s lives.

Methods: precisely according to the determined protocols, and it’s unreasonable and irrational medication should be avoided. Statistical analysis was performed in Shahid Rahimi Hospital of Khorramabad, Iran, from March 2018 to March 2019. Albumin administration for randomly selected patients receiving albumin in different wards was evaluated. The main sources to retrieve information were pharmacy drug folders, patient folders (including laboratory information), and nursing folders. Age, sex, weight, ward, albumin level, symptoms, and final dose were recorded for each patient. Contraindications to the administration of albumin or any caution in its use were also considered. Data were analyzed by using SPSS16 and Excel software. Independent T-test and Chi-square test were employed to compare quantitative and qualitative variables. 271 patients were studied, including 160 men and 111 women.

Results: The two male and female surgical wards with 41 patients had the highest percentage of patients admitted with albumin administration. Also, the most common cause of albumin administration in patients was hypoalbuminemia. 55% of albumin prescriptions in Shahid Rahimi Hospital of Khorramabad were irrational, driving a substantial financial burden for the healthcare system and patients. Among all the prescribed cases, only 5.2% were approved by the pharmacist. Finally, 77.1% of patients recovered, and 22.9% died.

Conclusion: Considering that the highest percentage of patients receiving albumin administration, both among patients with irrational administration and in general, were in men's and women's surgical wards, it is recommended that the drugs prescribed in these wards be further investigated and get pre- Approved by a pharmacist to prevent higher medical costs for patients and healthcare system.          

Keywords: Albumin; Hypovolemia; Cirrhotic Ascites; Septic Shock; Hyperstimulation Syndrome     


Full Text:

PDF

References


Talasaz AH, Jahangard-Rafsanjani Z, Ziaie S, et al. Evaluation of the Pattern of Human Albumin Utilization at a University Af-fliated Hospital. Archives of Iranian Medicine, (2012); 15(2): 85-87.

http://fda.gov.ir/item/463 [Internet]. 2019. Available from: http://fda.gov.ir/item/463

Abbas KM, Al-Rahmanny AHJ. Toxic effects of various oil concentrations obtained from Rosmarinus officinalis on Musca domestica adults (Diptera: Muscidae) in different time periods. Caspian Journal of Environmental Sciences, (2022); 20(2): 401-405.

Kleinman ME, Chameides L, Schexnayder SM, et al. Part 14: Pediatric advanced life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, (2010);122(3):876–908.

Ebrahimi Y, AL-Baghdady HFA, Hameed NM, Iswanto AH, Shnain Ali M, Hammoodi HA, Hashim Kzar H, Aravindhan S, Khodaei SM, Alikord M, Pirhadi M. Common fatty acids and polyphenols in olive oil and its benefits to heart and human health. Caspian Journal of Environmental Sciences, 2022; 1-7.

Caraceni P, Angeli P, Prati D, et al. AISF-SIMTI position paper: The appropriate use of albumin in patients with liver cirrhosis. Blood Transfusion, (2016);14(1):8–22.

Benetti G, Rosi S, Romano A, et al. Terlipressin given by continuous intravenous infusion versus intravenous boluses in the treatment of hepatorenal syndrome: A randomized controlled study. Hepatology, (2015);63(3):983–92.

Ortega R, Ginès P, Uriz J, et al. Terlipressin therapy with and without albumin for patients with hepatorenal syndrome: Results of a prospective, nonrandomized study. Hepatology, (2002);36(4 I):941–8.

Rodés J, Soriano G, Guevara M, et al. Terlipressin and Albumin vs Albumin in Patients With Cirrhosis and Hepatorenal Syndrome: A Randomized Study. Gastroenterology, (2008);134(5):1352–9.

Brierley J, Carcillo JA, Choong K, et al. Clinical practice parameters for hemodynamic support of pediatric and neonatal septic shock: 2007 update from the

American College of Critical Care Medicine. Critical Care Medicine, (2009);37(2):666–88.

Romanelli RG, La Villa G, Barletta G, et al. Long-term albumin infusion improves survival in patients with cirrhosis and ascites: An unblinded randomized trial. World Journal of Gastroenterology, (2006);12(9):1403–7.

Giefer MJ, Murray KF, Colletti RB. Pathophysiology, diagnosis, and management of pediatric ascites. Journal of Pediatric Gastroenterology and Nutrition, (2011); 52(5): 503–13.

NIEUWKAMP GA. Ovarian hyperstimulation syndrome. Emergency Medicine [Internet], (1994); 6(1):8-11.

Venetis CA, Kolibianakis EM, Toulis KA, et al. Intravenous albumin administration for the prevention of severe ovarian hyperstimulation syndrome: A systematic review and metaanalysis. Fertil Steril, (2011); 95(1): 188-196.3.

Pfeifer S, Butts S, Dumesic D, et al. Prevention and treatment of moderate and severe ovarian hyperstimulation syndrome: a guideline. Fertil Steril, (2016); 106(7): 1634–47.

Jee BC, Suh CS, Kim YB, et al. Administration of intravenous albumin around the time of oocyte retrieval reduces pregnancy rate without preventing ovarian hyperstimulation syndrome: A systematic review and meta-analysis. Gynecologic and Obstetric Investigation, (2010); 70(1): 47–54.

Bellver J, Muñoz EA, Ballesteros A, et al. Intravenous albumin does not prevent moderate-severe ovarian hyperstimulation syndrome in high-risk IVF patients: A randomized controlled study. Human Reproduction, (2003); 18(11): 2283–8.

Angeli P, Volpin R, Gerunda G, et al. The treatment of the type 1 hepatorenal syndrome (HRS) with the combined administration of midodrine and octreotide. Journal of Hepatology, (1998); 28:70.

Romanelli RG, La Villa G, Barletta G, et al. Long-term albumin infusion improves survival in patients with cirrhosis and ascites: An unblinded randomized trial. World Journal of Gastroenterology, (2006) ;12(9): 1403–7.

Moore KP, Wong F, Gines P, et al. The management of ascites in cirrhosis: Report on the consensus conference of The International Ascites Club. Hepatology, (2003); 38(1): 258–66.

Vermeulen Jr LC, Ratko TA, Erstad BL, et al. A Paradigm for Consensus: The University Hospital Consortium Guidelines for the Use of Albumin, Nonprotein Colloid, and Crystalloid Solutions. Archives of Internal Medicine [Internet], (1995); 27;155(4):373–9.

Abd Elaal MM, Zaghloul SG, Bakr HG, et al. evaluation of different therapeutic approaches for spontaneous bacterial peritonitis. Arab Journal of Gastroenterology [Internet], (2012);13(2):65–70.

Ring J, Messmer K. INCIDENCE AND SEVERITY OF ANAPHYLACTOID REACTIONS TO COLLOID VOLUME SUBSTITUTES. Lancet [Internet], (1977); 26 [cited 2019 Mar 1];309(8009):466–9.

Kappos L, Radue E-W, O’ Connor P, et al. New England Journal. The New England Journal of Medicine, (2010);362(5):387–401.

Hemolysis Associated with 25% Human Albumin Diluted with Sterile Water -United States, 1994-1998, (1994).

Mihara E, Hirai H, Yamamoto H, et al. "Active and water-soluble form of lipidated Wnt protein is maintained by a serum glycoprotein afamin/α-albumin".eLife.Feb, (2016); 5:44-63.

Erstad BL, Gales BJ, Rappaport WD. The use of albumin in clinical practice. Archives of Internal Medicine, (1991); 151: 901 – 911.

Vermeulen Jr LC, Ratko TA, Erstad BL, et al. A Paradigm for Consensus: The University Hospital Consortium Guidelines for the Use of Albumin, Nonprotein Colloid, and Crystalloid Solutions. Archives of Internal Medicine [Internet], (1995); 27;155(4):373–9.

Guthrie RD, Hines C. Use of intravenous albumin in the critically ill patient. American Journal of Gastroenterology, (1991); 86: 255-263.

Virgilio RW, Rice CL, Smith DE, et al. Crystalloid vs. colloid resuscitation: Is one better? A randomized clinical study. Surgery, (1979); 85: 129 – 139.

Golub R, Sorrento JJ, Cantu RJ, et al. Efcacy of albumin supplementation in the surgical intensive care unit: a prospective, randomized study. Critical Care Medicine, (1994); 22: 613-619.

Rubin H, Carlson S, DeMeo M, et al. Randomized, double-bind study of intravenous human albumin in hypoalbuminemic patients receiving total parenteral nutrition. Critical Care Medicine, (1997); 25: 249-252.

Salerno F, Badalamenti S, Lorenzano E, et al. Randomized comparative study of hemaccel vs. albumin infusion after total paracentesis in cirrhotic patients with refractory ascites. Hepatology, (1991); 13: 707 – 713.




DOI: http://dx.doi.org/10.62940/als.v9i4.1566

Refbacks

  • There are currently no refbacks.