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Research Snapshot Theater: Resuscitation, Adult and Pediatric

COLL(oid) to Arms: Albumin 5% in Pediatric Fluid Resuscitation

Monday, March 23, 2026
11:30 AM - 12:30 PM Central Time
Location: Connections Central - RST 17

  • Mitesh Patel, PharmD, MBA (he/him/his)

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • FS

    Felice Su, MD

    Pediatric Intensive Care Unit Medical Director
    Stanford University School of Medicine

    Disclosure information not submitted.

  • JM

    Jeff Moss, PharmD, BCCCP

    Medication Safety Officer / Clinical Effectiveness Specialist Pharmacist
    Lucile Packard Children's Hospital Stanford

    Disclosure information not submitted.

Introduction: Albumin 5% is commonly used for fluid resuscitation in critically ill pediatric patients, despite consensus guideline recommendations to utilize crystalloids as the first-line. Quality improvement efforts have been developed to optimize albumin 5% usage at pediatric healthcare systems. These initiatives aimed to curb the injudicious use of albumin 5% in scenarios when not clinically indicated. The purpose of this project is to conduct a medication use evaluation to assess prescribing patterns of albumin 5% at Lucile Packard Children’s Hospital Stanford (LPCHS) to identify opportunities for improvement.


Methods: Patients were included if they were less than or equal to 18 years old and received a dose of albumin 5% between January 1, 2025, and June 30, 2025 at LPCHS. Patients who received albumin 5% as part of apheresis and hemodialysis order sets were excluded. Patients were assessed based on the volume of crystalloid boluses administered prior to albumin. Prescribing and dispensing practices were evaluated based on order source and override status.


Results: 88 patients received albumin 5%, accounting for 334 administrations. The average age was 6.5 (±2.1) years, and average weight was 16 (±7.2) kg respectively. 63 (71.6%) patients received 223 (66.7%) crystalloid boluses in the six hours prior to albumin. Of patients who received crystalloid before albumin administration, the average administered volume was 7.6 (± 2.3) mL/kg.


Conclusions: The majority of patients receiving albumin 5% also received crystalloids within 6 hours prior to administration. The comparatively low average volume of crystalloid administered prior to albumin infusion underscores opportunities to enhance adherence to evidence-based fluid resuscitation protocols.