CPB · Albumin priming · Educational reference
Pediatric / Neonatal CPB Albumin Priming
Estimate albumin concentration at CPB initiation and calculate additional albumin for a user-selected target concentration.
An educational/research calculator that has not been clinically validated. The source paper is not a patient study validating prediction accuracy or clinical outcomes. The adult and pediatric pages separate input workflows; they do not represent distinct validated age-specific equations.
View Clinical Evidence and the source paper ↓Clinical Evidence
Calculation-model development · No clinical validation in patients
A predictive model for prudent albumin priming in cardiopulmonary bypass circuits
Julie Fenske, Isabel Centner · Journal of ExtraCorporeal Technology · 2026;58:223–227
DOI: 10.1051/ject/2026016
This paper presents a spreadsheet model for calculating albumin dilution during CPB priming and estimating the albumin quantity needed for a user-selected target concentration.
The study did not validate agreement between predicted and measured values in a patient cohort, establish appropriate treatment targets, or demonstrate reduced edema or improved outcomes. Pediatric and neonatal use also requires separate validation. This calculator adds an unvalidated plasma-volume extension including RBC and FFP, distinct from the source model.
Formulas, assumptions and references
Formula details
BV = weight (kg) × user-selected blood-volume coefficient (mL/kg)
Paper Figure 3 reproduction: native albumin mass M₀ = A₀ × BV / 100; mixing compartment V = BV + total prime
Plasma-volume extension: patient PV = BV × (1 − patient Hct/100); RBC noncellular volume = RBC volume × (1 − RBC Hct/100)
Plasma-volume extension: V = PV + albumin-free fluid + albumin product volume + RBC noncellular volume + FFP
M = native albumin mass + existing albumin product mass (g) + RBC noncellular albumin mass + FFP albumin mass; predicted concentration = 100M/V
Add-volume strategy: additional product volume x(mL) = (T × V − 100M)/(S − T), when S > T and the current concentration is below the target
Equal-volume replacement: x(mL) = (T × V − 100M)/S; x must not exceed the available albumin-free fluid volume
S = selected product concentration (g/dL), T = user-selected target (g/dL). Additional mass (g) = S × x / 100. Intermediate values are not rounded.
Rather than transcribing the ambiguous printed units and multiplication signs in Figure 2, this implementation uses dimensionally consistent g/dL-to-mL conversions matching the Figure 3 example. The source model uses total blood volume. The plasma-volume extension and add-volume strategy including product volume are separate, unvalidated ECMO Info implementations.
RBC and FFP concentrations are measured values or explicitly selected assumptions. Washed RBC, additive solutions, product composition and retained circuit volume affect uncertainty. Absolute COP is not calculated from albumin alone, and albumin is not substituted for total protein in the source COP equation. This tool has not been validated for dosing during ongoing ECMO.
Fenske J, Centner I. A predictive model for prudent albumin priming in cardiopulmonary bypass circuits. J Extra Corpor Technol. 2026;58:223–227. Source article: CC BY 4.0. Dimensional notation has been clarified and a separate extension model and web UI added. This implementation has not been reviewed or endorsed by the authors.