Molina L, Mesa A, Pinto R, Gómez M, Quijano F
Arch Inst Cardiol Mex. 1983 Mar-Apr;53(2):153-7.
Changes in colloidosmotic pressure (COP) were observed in 15 patients submitted to hemodilution for extracorporeal circulation. Preoperative laboratory tests were within normal limits. COP before hemodilution was above 15 mmHg in 14 cases and 12.6 mmHg in one 9-month-old patient, the mean CP was 18.17 mmHg. During extracorporeal circulation the mean COP decreased to 55% of its initial value (9.92 mmHg). Within the first 4 hrs of the postoperative recovery 13 had COP over 11 mmHg; the remaining two died of cardiorespiratory failure with a COP of less than 7 mmHg. One patient that recovered 100% of its initial COP value between 20 and 24 hrs of the postoperative period had his COP decreased to 6 mmHg and developed fatal pulmonary edema. One patient -who died acute bleeding did not diminish his COP under 12.5 mm Hg. We can conclude that COP lower than 10 mmHg can produce fatal cardiorespiratory failure. Extracorporeal circulation time does not influence the COP recovery. Acute bleeding does not diminish COP values. Hemodilution significantly reduces COP; its recovery and stabilization over 11 mmHg are of prognostic value. COP monitoring is a simple and useful method.
对15例接受体外循环血液稀释的患者的胶体渗透压（COP）变化进行了观察。术前实验室检查均在正常范围内。血液稀释前14例患者的COP高于15 mmHg，1例9个月大的患者为12.6 mmHg，平均COP为18.17 mmHg。体外循环期间，平均COP降至初始值的55%（9.92 mmHg）。术后恢复的前4小时内，13例患者的COP超过11 mmHg；其余2例死于心肺衰竭，COP低于7 mmHg。1例在术后20至24小时内COP恢复至初始值100%的患者，其COP降至6 mmHg并发生致命性肺水肿。1例死于急性出血的患者，其COP未降至12.5 mmHg以下。我们可以得出结论，COP低于10 mmHg可导致致命性心肺衰竭。体外循环时间不影响COP的恢复。急性出血不会降低COP值。血液稀释显著降低COP；其恢复并稳定在11 mmHg以上具有预后价值。COP监测是一种简单且有用的方法。
