Table I.

Practical recommendations for the prescription of human serum albumin at the S. Orsola-Malpighi University Hospital, Bologna, Italy⁵⁶.

Acute diseases	First-line treatment	Second-line treatment
Hypovolaemic shock	Colloid/Crystalloid solutions	Human albumin if: - Sodium intake restriction - Hypersensitivity to colloids or crystalloids - Lack of response to combined use of colloids and crystalloids
Major surgery: - Cardiovascular - Other surgery	Colloid/Crystalloid solutions	Human albumin if: - Lack of response to combined use of colloid/crystalloid
Burns	Colloid/Crystalloid solutions	Human albumin plus crystalloid solutions if: - Lack of response to colloid or crystalloid solutions alone - Severe burns (>50% body surface)
Paracentesis	Human albumin 8 g/L of removed ascites if paracentesis >4 L
Spontaneous bacterial peritonitis	Human albumin 1.5 g/kg at diagnosis of 1 g/kg on third day + antibiotic therapy
Hepatorenal syndrome	Human albumin 1 g/kg at diagnosis followed by 20–40 g/die + vasocontrictors
Ascites	Diuretic treatment	Human albumin if: - Ascites resistant to diuretics
Plasmapheresis	Human albumin if plasma changes >20 mL/kg per week
Protein wasting enteropathy/malnutrition	Enteral or parenteral nutrition	Human albumin if: - Severe diarrhoea (>2 L/die) - Albuminaemia <2 g/dL - Clinical hypovolaemia