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NICU guideline identifier

Blood products - albumin (Newborn Services)

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There are two types of Albumin used in NICU - Albumex TM4 and Albumex TM20.

  • Both forms of Albumin require informed consent with parents signing an Ageement to Treatment form (CR0111)
  • Both are prescribed on the blood transfusion/IV fluid chart (CR5541)
  • Both are ordered via the NZBS requisition form (111F01802)
  • Both products are prefiltered so do not require filtering prior to administration
  • For information on checking, administration, monitoring, documentation and transfusion reactions, see  Blood products - red cell transfusion

Albumex TM4

  • Available in two sizes - 500ml (20g/500ml) and 50ml (2g/50ml).
  • In NICU we usually use the 50ml size. 
  • 4% albumin is free of risk of transmission of known viral diseases (heat inactivated). 
  • Dose = 10-20mls/kg
  • Once opened use immediately as the product contains no antimicrobial agent.
  • Should be straw colour. Should not be cloudy.

Albumex TM20

  • Albumex TM20 is free of the risk of infectious disease as it is heat inactivated. 
  • Albumex TM20 comes in two sizes - 10ml(2g/10ml) and 100ml(20g/100ml) and is made from large pools of New Zealand donor plasma. It is used for babies with low protein and oedema.
  • It should be administered through a standard IV giving set (no filter is required)
  • TM20 can be utilised 2 ways:
    a)  As a volume expander diluted 1 part to 4 parts of 0.9% sodium chloride.
    b) To draw fluid out of the tissues - use full strength
    Albumex TM20 draws 4 volumes of fluid from the extra cellular fluid into the circulation.
    Thus, 20ml of Albumex TM20 results in approximately 80ml increase in the circulating volume.
    This can cause volume overload, particularly in the presence of renal failure.
    It should be given undiluted over 1 hour (approximately). 2gm in 10ml is equal to 40ml Albumex TM4.
    Dose for hypoprotinaemia 0.5 - 1g/kg/dose (2.5 - 5ml/kg/dose)
  • Once the bottle is opened it must be used straight away.



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Document Control

  • Date last published: 01 August 2018
  • Document type: Clinical Guideline
  • Services responsible: Neonatology
  • Owner: Newborn Services Clinical Practice Committee
  • Editor: Sarah Bellhouse
  • Review frequency: 2 years