Colloid Oncotic Pressure and Body Water Dynamics in Septic and Injured Patients
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Colloid oncotic pressure (COP) and fluid shifts were studied in 43 septic (SS) patients and 33 injured (HS) patients (ISS = 48.2). During maximal postresuscitation fluid retention, plasma volume (PV/RISA), red cell volume (RBC/51Cr), inulin space (ECF), and COP were measured. Interstitial space (IFS), PV/IFS ratio, and correlation coefficients (r) were calculated. A subgroup of 22 SS patients and 22 HS patients of equal study weight were also compared. Septic patients had greater IFS expansion (17.6 L vs. 11.5 L) than HS patients who, by inference, had more intracellular expansion. Expansion of IFS in SS patients correlated (r = -0.76, p < 0.02) with reduced plasma COP; this was not seen in HS patients (r = -0.09, p > 0.35). In contrast, plasma COP correlated (r = 0.72, p < 0.001) with PV/RISA in HS patients but not in SS patients (r = 0.09, p > 0.35). We conclude: (1) SS patients with greater IFS expansion that correlates with reduced plasma COP likely have increased capillary permeability; and (2) HS patients with less IFS expansion that does not correlate with reduced plasma COP likely have maintained capillary permeability with altered IFS matrix configuration causing reduced protein exclusion.
Lucas, C. E.,
Ledgerwood, A. M.,
Rachwal, W. J.,
& Saxe, J. M.
(1991). Colloid Oncotic Pressure and Body Water Dynamics in Septic and Injured Patients. The Journal of Trauma: Injury, Infection, and Critical Care, 31 (7), 927-933.