Effect of Implementation of an Albumin Criteria for Utilization at an Academic Medical Center

Introduction: Use of Intravenous Albumin: A Guideline from the International Collaboration for Transfusion Medicine Guidelines published in 2024 made fourteen recommendations regarding albumin utilization. This project aimed to evaluate if intravenous albumin utilization at a tertiary care academic medical center met guideline recommendations and if implementation of an Intravenous Albumin Criteria for Utilization would lead to a reduction in inappropriate albumin utilization.


Methods: This was a single-center, pre-post intervention analysis of medication orders placed at a tertiary care academic medical center 90 days before and after publication of and education on Criteria for Utilization between December 19, 2024 and June 17, 2025. Medication orders for IV albumin were included in the analysis if they were associated with a patient > 18 years of age. The electronic medical record was queried for all medication administrations of IV albumin. Intravenous Albumin Criteria for Utilization was drafted, approved by the Pharmacy & Therapeutics Committee in March 2025, and education was disseminated prior to and post criteria for utilization. The primary outcome was the percentage of orders not meeting criteria for utilization between the endpoints prior to criteria publication and following criteria publication.


Results: N= 1428 orders (pre; n = 824 & post; n = 604) met inclusion criteria and were included in the analysis. The primary outcome was difference in percentage of orders not meeting criteria for utilization and was found to be the following 70.3% versus 64.7% (p=0.0271). Pre- vs. post-intervention, n=240 vs. n= 185 orders were associated with a patient with a diagnosis of heart failure and n= 225 vs. n=127 orders were in the ICU. The estimated direct cost savings from number of albumin vials was estimated to be 36.4% from pre-post intervention.


Conclusions: There was a statistical significance in reduction of IV albumin orders not meeting criteria for utilization pre-and-post panel implementation. Further ongoing data collection and analysis is planned and an order panel has been approved for system-wide implementation which may support adherence to criteria for utilization.