How much fluid does 5% albumin 'pulls' more than 0.9%Saline ? 

Its a common knowledge that albumin increases more intravascular volume than crystalloids. BUT have you wondered by how much ? and where does that volume comes from. Answer may surprise you. We will review the literature on this topic and calculate the fluid shifts that occur with Saline, 5% albumin and 25% albumin.
references:
1. derangedphysio...
2. Human serum albumin homeostasis: a new look at the roles of synthesis, catabolism, renal and gastrointestinal excretion, and the clinical value of serum albumin measurements. International Journal of General Medicine 2016:9 229-255
3. Albumin administration in internal medicine: A journey between effectiveness and futility. European Journal of Internal Medicine 117 (2023) 28-37
4. Kinetics of 5% and 20% albumin: A controlled crossover trial in volunteers. Acta Anaesthesiol Scand. 2022;66:847-858
5. Distribution of normal saline and 5% albumin infusions in cardiac surgical patients. Crit Care Med 2001; 29:2299 -2302
6. Plasma volume expansion after infusion of 5%, 20% and 25% albumin solutions in patients. Resuscitation, 5,85-92
7. Changes in serum albumin concentration and volume expanding effects following a bolus of albumin 20% in septic patients. British Journal of Anaesthesia 92 (6): 821±6 (2004)
8. CHEMICAL, CLINICAL, AND IMMUNOLOGICAL STUDIES ON THE PRODUCTS OF HUMAN PLASMA FRACTIONATION. VI. THE OSMOTIC PRESSURE OF PLASMA AND OF SERUM ALBUMIN. By G. SCATCHARD, A. C. BATCHELDER, AND A. BROWN
9. INCREASED VASCULAR PERMEABILITY: A MAJOR CAUSE OF HYPOALBUMINAEMIA IN DISEASE AND INJURY. Lancet, April 6, 1985
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