부산대학교 도서관

Background: Albumin is a human blood product associated with risks to patients and subject to supply shortfalls. It is expensive compared with synthetic colloid and crystalloid alternatives. An audit performed in 2003 found that albumin was being used for a wide variety of indications in British Columbia, many of which were not supported by the literature. Based on these results, evidence-based guidelines for albumin use were developed and released in October 2007. The guidelines specified "Indications for which albumin may be used" and "Indications for which albumin should not be used." The audit was repeated in 2009 to determine if the introduction of guidelines had any effect on albumin prescribing practices in BC. Methods: Nine of the 13 hospitals audited in 2003 were audited again in 2009. Transfusion medicine technologists in participating hospitals recorded the specialty of the ordering physician and the indication for albumin use for each order filled during both audit periods. Results: The three most common clinical entities requiring albumin reported in 2009 are listed as appropriate indications for this blood product in the provincial guidelines. In stark contrast, the most common clinical entities requiring albumin reported in 2003 are listed as inappropriate in the guidelines. However, along with this improvement in prescribing practice, the 2009 audit also shows that many clinicians are still using albumin for indications that are not supported by the literature. The major users of albumin continue to be cardiac surgery and internal medicine, particularly hematology and nephrology. Conclusions: While some progress has been made, continuing education is required to encourage clinicians to follow evidence-based guidelines and ensure that albumin is prescribed for patients who are most likely to benefit. [ABSTRACT FROM AUTHOR]