Albumin as a drug: its biological effects beyond volume expansion

Shailesh Bihari, Jonathan Bannard-Smith, Rinaldo Bellomo

Research output: Contribution to journalReview articlepeer-review

22 Citations (Scopus)


Albumin is the most abundant and perhaps most important protein in human blood. Research has identified many of albumin's possible roles in modulating acid-base balance, modifying inflammation, maintaining vascular endothelial integrity, and binding endogenous and exogenous compounds. Albumin plays a key role in the homeostasis of vascular endothelium, offering protection from inflammation and damage to the glycocalyx. Albumin binds a diverse range of compounds. It transports, delivers and clears drugs, plus it helps with uptake, storage and disposal of potentially harmful biological products. The biological effects of albumin in critical illness are incompletely understood, but may enhance its clinical role beyond use as an intravenous fluid. In this article, we summarise the evidence surrounding albumin's biological and physiological effects beyond its use for plasma volume expansion, and explore potential mechanistic effects of albumin as a disease modifier in patients with critical illness.

Original languageEnglish
Pages (from-to)257-265
Number of pages9
JournalCritical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine
Issue number3
Publication statusPublished - 1 Sept 2020


  • Albumin
  • modulating acid–base balance
  • vascular endothelial integrity


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