a. In recent years, plasma substitutes have become popular since they provide
volume and colloid without the risk of hepatitis or acquired immunodeficiency syndrome
(AIDS). Five percent normal serum albumin in saline and five percent plasma protein
fraction (PPF) are available in 250-ml and 500-mI containers (see Table 3-3). Except
for electrolyte concentrations, they are quite similar. Both are useful for the treatment of
hypovolemic shock, burns, and other clinical conditions in which both volume and
colloid must be replaced. Albumin is also available as a concentrate with little sodium
chloride added (25 percent salt-poor albumin). Considerable caution must be used
since the albumin concentration may raise the oncotic pressure in the vessels
dramatically, drawing large volumes of water from the tissues into the vascular space.
This may, in turn, produce cardiac overload.
b. The value of any of these albumin solutions in the treatment of chronic
hypoalbuminemic states, such as cirrhosis, protein losing enteropathy, or cachexia, has
not been established.
Table 3-3. Plasma substitutes. (Continued)