HPE Human albumin handbook | Page 14

in combination with terlipressin , norepinephrine , midodrine , or octreotide on survival in patients with hepatorenal syndrome . 38 For patients with Type 1 HRS , every 100g increment of the cumulative dose of human albumin improved the survival rate ( hazard ratio = 1.15 ; 95 % CI 1.02 – 1.31 ) with statistic difference . The initial dose of albumin was 1g / kg and 20-40g / d was given according to the central venous pressure and / or volume overload until terlipressin was discontinued . There is very limited information on the use of vasopressors plus albumin in Type 2 HRS . Although combined therapy may improve renal function , the recurrence rate of HRS after discontinuation is still very high .
Conclusions In summary , along with the advancement of clinical understanding of human albumin and its expanded clinical indications , misuses of human albumin have been seen in clinical practice . With the development of evidence-based medicine methodologies and clinical guidelines , RCTs and meta-analyses in the field of hepatology have shown the effectiveness of albumin in treating liver cirrhosis and ascites , preventing circulation dysfunction after LVP , preventing renal failure secondary to SBP , treating hepatorenal syndrome in combination with vasopressors as well as for the treatment or prevention of other serious complications of liver cirrhosis . However , most of these study data have originated from European countries . When interpreting and applying this evidence , Chinese physicians should take into consideration China ’ s medical conditions , patient wishes and health economics . Considering the safety of blood transfusion products , resource limitations , and drug economics , the use of human should be standardised so as not to waste medical resources .
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