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[不同胎龄新生儿呼吸功能不全的胶体渗透压值。测量值与计算值的比较呈现]

[Colloid osmotic pressure values of respiratory insufficiency in neonates of various gestational ages. Comparative presentation of measured and calculated values].

作者信息

Abel M, Otto J, Vogel W

出版信息

Infusionsther Klin Ernahr. 1984 Feb;11(1):35-8.

PMID:6706384
Abstract

Colloid osmotic pressure (COP) is an important physiochemical factor in intercompartmental body fluid movements. In actual medical practise COP is notably measured in adult intensive care patients to control oncotic fluid therapy. Recent advances in oncometry technics led to rapid and accurate COP determinations also on very small sample volumes of neonatal intensive care patients. In 47 preterm and term newborns we determined during the first 9 days of life COP changes of calculated and measured values. The COP of patients with respiratory distress was compared to COP levels of newborns without respiratory problems. Until the sixth day of life preterm and term newborns with respiratory insufficiency showed significantly lower COP than normal newborns. The poorest correlation between measured and calculated COP was found in preterm infants with need of respiratory support therapy. During the whole observation period a rise of COP could be observed in all gestational age groups. This tendency should be considered before and during albumin therapy in newborns to avoid oncotic fluid overload, e.g. in a preterm infant. When volume replacement therapy is required in very young patients we advise measurement of COP as a guide to fluid selection.

摘要

胶体渗透压(COP)是体内不同腔隙间体液移动的一个重要物理化学因素。在实际医疗实践中,COP主要用于测量成年重症监护患者,以控制胶体液治疗。近年来,渗透压测定技术的进步使得即使是对新生儿重症监护患者的极少量样本,也能快速、准确地测定COP。我们对47例早产儿和足月儿在出生后的前9天内测定了计算值和测量值的COP变化。将呼吸窘迫患儿的COP与无呼吸问题新生儿的COP水平进行比较。直到出生后第6天,患有呼吸功能不全的早产儿和足月儿的COP明显低于正常新生儿。在需要呼吸支持治疗的早产儿中,测量的COP与计算的COP之间的相关性最差。在整个观察期内,所有孕周组的COP均有升高趋势。在对新生儿进行白蛋白治疗之前和期间,应考虑到这种趋势,以避免胶体液过载,例如在早产儿中。当非常年幼的患者需要进行容量替代治疗时,我们建议测量COP,以指导液体的选择。

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