Changes in colloid oncotic pressure during and after cardiopulmonary bypass

Abstract

Thirty-one patients undergoing open-heart surgery for uncomplicated coronary artery disease were studied. All patients had dextran 70 (Macrodex, Pharmacia) in the priming solution. In Group I patients (n = 16) 3.5% dextran 40 (Rheomacrodex, Pharmacia) was added to the cardioplegic solution. Group II patients (n = 15) received our standard crystalloid cardioplegia. A higher colloid oncotic pressure (COP) was noticed in Group I during cardiopulmonary bypass (CPB) and immediately postoperatively. The albumin levels were higher in Group II during and after bypass. No differences could be demonstrated in the concentrations of total serum protein. Preoperative levels of COP were reached two hours postoperatively and 24 hours postoperatively for albumin and total proteins. The addition of dextran 40 to the cardioplegic solution did not influence haemodynamic parameters. The clinical course was uneventful in both groups.

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References

Saunders CR , Carlisle L. , Bick RL Hydroxyethyl starch versus albumin in cardiopulmonary bypass prime solutions . Ann Thorac Surg 1983; 36: 532-39.

Sanchez de Léon R. , Paterson JL , Sykes MK Changes in colloid osmotic pressure and plasma albumin concentration associated with extracorporeal circulation. BrJAnaesth 1982; 54: 465-73.

Meretoja O. , Jalonen J. , Laaksonen V. , Näntø V. , Inberg MV Serum oncocity and myocardial oxygen balance during hemodilution in open-heart surgery. Ann Clin Res 1981; 13 (Suppl. 33): 65-71.

Lindberg H. , Svennevig J-L. , Vatne K. , Lilleaasen P. , Abdelnoor M.

Early postoperative changes with different priming solutions in open-heart surgery. Scand J Thor

Cardiovasc Surg 1985 ; 19: 39-44.

Reed RK , Lilleaasen P. , Lindberg H. , Stokke O. Dextran 70 versus donor plasma as colloid in open-heart surgery under extreme hemodilution. Scand J Clin Lab Invest 1985 ; 45: 269-74.

Ljungstrøm K-G. , Renck H. , Hedin H. , Richter W. , Rosberg B. Prevention of dextran-induced anaphylactic reactions by hapten inhibition. Acta Chir Scand 1983; 149: 341-48.

Dixon JW ed. BMDP statistical software. Los Angeles: University of California Press, 1983.

Sade RM , Stroud MR , Crawford FAJr et al. A prospective randomized study of hydroxyethyl starch, albumin and lactated Ringer's solution as priming fluid for cardiopulmonary bypass . J Thorac Cardiovasc Surg 1985; 89: 713-22.

Yeoman PM , Vence-Pastor DE , Rithalia Svs. Changes in colloid osmotic pressure in patients undergoing cardiothoracic surgery. Resuscitation 1981; 9: 307-13.

10.

Rackow EC , Fein LA , Leppo J. Colloid osmotic pressure as a prognostic indicator of pulmonary oedema and mortality in the critically ill. Chest 1977 ; 72: 709-13.

11.

Weil MH , Henning RJ , Puri VK Colloid oncotic pressure: clinical significance. Crit Care Med 1979; 7: 113-16.

12.

Morisette MP , Weil MH , Shubin H. Reduction in colloid osmotic pressure associated with fatal progression of cardiopulmonary failure. Crit Care Med 1975 ; 3: 115-17.

13.

Foglia RP , Steed DL , Folette DM et al. Iatrogenic myocardial oedema with potassium cardioplegia. J Thorac Cardiovasc Surg 1979; 78: 217.

14.

Weil MH, Carlson RW. Editorial: Colloid osmotic pressure and pulmonary oedema. Chest 1977; 72 (6): 692-93.

15.

Tranbaugh RT , Lewis FR Mechanisms and aetiologic factors of pulmonary oedema. Surg Gyn Obstet 1984; 158: 193-206.