[The role of albumin in the treatment of critically ill patients in intensive care].

Albumin is the most abundant plasma protein, playing a key role in maintaining oncotic pressure, modulating the inflammatory response and transporting both endogenous and exogenous substances. Its immunomodulatory and antioxidant properties further support the role in mitigating systemic inflammation. Albumin supplementation has gained increasing attention as a therapeutic strategy in critically ill patients in the intensive care setting. Clinical trials and meta-analyses suggest that albumin administration can improve hemodynamic stability, enhance fluid responsiveness, and reduce positive fluid balance in severe sepsis and septic shock, particularly in patients with hypoalbuminemia. Hypoalbuminemia is common among septic patients and serves as an important marker of poor outcomes, organ dysfunction, and disease severity. It represents a major determinant of morbidity and mortality in critically ill patients, with its development largely driven by uncontrolled immune responses during inflammation and sepsis, leading to endothelial dysfunction and increased capillary leakage. Current therapeutic guidelines advocate individualized fluid therapy, with albumin preferentially administered to patients requiring substantial crystalloid resuscitation and/or presenting with low serum albumin levels. Despite recognized benefits, the optimal timing, dosing, and patient selection for albumin therapy remain subjects of ongoing investigation. Serum albumin levels not only reflect disease severity but also represent a rational therapeutic target. Based on evidence-based strategies, achieving near-target albumin concentrations in the intensive care setting may improve the condition and outcomes of critically ill, septic patients. Orv Hetil. 2026; 167(12): 456-465.