Albumin is used commonly across a wide range of clinical settings to improve hemodynamics, to facilitate fluid removal, and to manage complications of cirrhosis. The International Collaboration for Transfusion Medicine Guidelines developed guidelines for the use of albumin in patients requiring critical care, undergoing cardiovascular surgery, undergoing kidney replacement therapy, or experiencing complications of cirrhosis. Cochairs oversaw the guideline development process and the panel included researchers, clinicians, methodologists, and a patient representative. The evidence informing this guideline arises from a systematic review of randomized clinical trials and systematic reviews, in which multiple databases were searched (inception through November 23, 2022). The panel reviewed the data and formulated the guideline recommendations using Grading of Recommendations Assessment, Development and Evaluation methodology. The guidelines were revised after public consultation. The panel made 14 recommendations on albumin use in adult critical care (three recommendations), pediatric critical care (one recommendation), neonatal critical care (two recommendations), cardiovascular surgery (two recommendations), kidney replacement therapy (one recommendation), and complications of cirrhosis (five recommendations). Of the 14 recommendations, two recommendations had moderate certainty of evidence, five recommendations had low certainty of evidence, and seven recommendations had very low certainty of evidence. Two of the 14 recommendations suggested conditional use of albumin for patients with cirrhosis undergoing large-volume paracentesis or with spontaneous bacterial peritonitis. Twelve of 14 recommendations did not suggest albumin use in a wide variety of clinical situations where albumin commonly is transfused. Currently, few evidence-based indications support the routine use of albumin in clinical practice to improve patient outcomes. These guidelines provide clinicians with actionable recommendations on the use of albumin.

中文翻译：

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静脉注射白蛋白的使用：国际输血医学合作指南的指南

白蛋白通常用于多种临床环境，以改善血流动力学、促进液体清除以及控制肝硬化并发症。国际输血医学合作指南制定了针对需要重症监护、接受心血管手术、接受肾脏替代治疗或经历肝硬化并发症的患者使用白蛋白的指南。联合主席监督指南的制定过程，小组成员包括研究人员、临床医生、方法学家和患者代表。本指南的证据来自对随机临床试验和系统评价的系统评价，其中检索了多个数据库（自成立至 2022 年 11 月 23 日）。专家组审查了数据，并使用建议评估、制定和评估分级方法制定了指南建议。该指南经公众咨询后进行了修订。专家组就白蛋白在成人重症监护（三项建议）、儿科重症监护（一项建议）、新生儿重症监护（两项建议）、心血管手术（两项建议）、肾脏替代治疗（一项建议）和并发症中的使用提出了 14 项建议肝硬化（五项建议）。在这 14 项建议中，两项建议的证据质量中等，五项建议的证据质量较低，七项建议的证据质量非常低。 14 条建议中的 2 条建议对接受大量腹腔穿刺术或患有自发性细菌性腹膜炎的肝硬化患者有条件地使用白蛋白。 14 项建议中的 12 项并未建议在通常输注白蛋白的各种临床情况下使用白蛋白。目前，很少有证据支持在临床实践中常规使用白蛋白来改善患者的预后。这些指南为临床医生提供了有关白蛋白使用的可行建议。