When do you give exogenous albumin in an attempt to reduce risk of ifosfamide induced encephalopathy?

We don’t routinely give albumin as prophylaxis for ifosfamide induced encephalopathy (IIE). While there is an association between hypoalbuminemia and the risk of IIE, prophylactic replacement with albumin doesn’t appear to reduce the risk based on two retrospective studies at academic medical centers.

In one study at the University of Kansas study, patients were stratified based on their risk factors for IIE. This found that there was an increased risk of IIE in the high risk group, regardless ...