lead
< span>Transfusion of blood products such as albumin is a very common thing in clinical practice, but it is such a common thing. The question of an intern made me understand that I am about albumin. There are so many things I don’t know!
“Xiao Li, this patient is typical of hypoalbuminemia, so we will give him Use albumin to correct hypoalbuminemia. Generally, half an hour after the albumin infusion, we also need to push furosemide (furosemide) intravenously, so don’t forget it at that time.”
“Okay, I understand, why use furosemide, teacher, what is the principle?”
“General doctor’s orders are prescribed like this. As for the principle, I really haven’t delved into it. You reminded me. I’ll go back and check and tell you tomorrow, okay?”
After some operations on HowNet, Lilac, Baidu, etc., I finally understood the following questions:
1,
Why do I push furosemide after transfusion of albumin?
This is related to the water-locking function of albumin. Albumin is involved in the regulation of water balance inside and outside the blood vessels. Intravenous infusion of albumin can change the plasma colloid osmotic pressure, allowing interstitial water to enter the blood vessels. 1 gram of albumin can retain 18 mL of circulating water, 10 grams of The albumin can be expanded to nearly 200mL. After the interstitial fluid enters the blood vessels, the edema of the interstitial space is relieved, so many patients with edema in clinical practice will infuse albumin to relieve the symptoms of edema.
Meanwhile, infusion of albumin will increase the workload of the heart caused by the increase in blood volume, thus partially The patient needs to use diuretics to reduce the load on the heart. Therefore, diuretics are generally used half an hour after albumin infusion, especially for patients with poor cardiac function.
2,
Why should I dilute the albumin properly?
A sudden increase in plasma protein content during a large infusion of albumin, resulting in an increase in plasma colloid osmotic pressure High, a large amount of water in the interstitial space flows into the blood vessels, resulting in tissue dehydration. Therefore, proper dilution can avoid this problem. Generally, 5% glucose injection or sodium chloride injection can be appropriately diluted for intravenous drip (a blood transfusion set with a filter device should be used).
3,
Why is the albumin infusion rate slow?
Albumin is required to be infused slowly, also to prevent the rapid increase in plasma protein concentration caused by Tissue dehydration.
4.
Albumin is a tonic ?
No, because albumin does not participate in the body’s immune process, and globulin is involved in the body’s immunity. Many people have misunderstandings about albumin, thinking that albumin can improve immunity or resistance. Decreased immunity.
5,
Is albumin a nutritional supplement?
Albumin is not a nutritional supplement. Albumin transfusion to subjects with normal albumin content can also inhibit their own albumin synthesis. Human serum albumin contains few essential amino acids, is expensive, and has a long half-life (about 21 days). Albumin infusion cannot play a nutritional role in a short period of time. Patients with malnutrition should emphasize parenteral and parenteral nutrition to properly provide nutrients and nutrients. heat. Moreover, the human body cannot use protein directly, and it can be used after it is degraded into amino acids. Its nutritional and economic value is far less than that of directly supplementing amino acid preparations.
Then, here comes the point, the procedure and precautions for our clinical infusion of albumin are: What?
Process and Considerations
< /p>
(1) Flush the tube with normal saline before and after albumin infusion, one is to avoid adverse reactions in contact with other drugs, and the other is to reduce the waste of albumin.
< span>(2) Infusion rate:For different concentrations of albumin, the infusion rate requirements are also different. The infusion rate of 5% albumin is 2-4 mL·min -1; 20% or 25% albumin is 1 mL·min-1, preferably no more than 2 mL per minute. The infusion rate for children is required to be slower, which is 1/2 or 1/4 of the infusion rate for adults. For the first 15 minutes, special attention should be paid to a slow speed, gradually increasing to the above speed.
(3 ) infusion set: Use a blood set with a filter set if possible.
(4) Precautions: Refer to the instruction manual of Tonglu Bio-Human Albumin, as shown below Shown:
Okay, about white How much do you know about protein?
As a clinical nurse, executing doctor’s orders is our basic job. Get the job done quickly and without errors. But a question from an intern reminded me that every nurse should refuse to be a simple order taker.
You should think deeply about why when you execute the doctor’s orders, think about why when you face clinical problems, and even more when you have doubts. We must think deeply about why, and try our best to solve the confusion in person. Over time, we will surely grow into a backbone nurse with solid knowledge and outstanding professional ability.
References:
Zhang Min. Human plasma Physiological function and clinical application of albumin[J]. Sichuan Journal of Physiological Sciences, 2011, 33(1):36-38.
Source: Critical Care
Recommended Reading
Add group: All kinds of specialized nursing WeChat groups, join now
< strong>Submission:Nurse-related original manuscripts are welcome
Video number: Nursing dry goods and large Coffee Live
Follow: WeChat Official Accounts by Nursing Department
Buy Books: span>Nursing books, click “read the original text” below to buy