Sola A, Gregory G A
Crit Care Med. 1981 Aug;9(8):568-72. doi: 10.1097/00003246-198108000-00002.
Colloid osmotic pressure (COP) is an important regulator of fluid movement and can now be measured simply and reliably. The authors used the 4100 Wescor Colloid Osmometer to define COP values and its relation to total protein concentration (TP) in different groups of newborns. The mean COP was 19.4 +/- 2.2 (SD) torr in 99 term infants delivered vaginally and 16.0 +/- 2.1 in 40 term infants delivered by cesarean section (p less than 0.005). The COP was lower in those born operatively without preceding labor (14.9 +/- 1.8). COP correlated well with TP (r = 0.92) in term infants. In 60 sick preterm infants with 362 determinations, COP (12.5 +/- 2.5) was different from term infants (p less than 0.001) and the correlation with TP was poor (r = 0.64). Different therapeutic modalities were found to affect COP widely. Crystalloid infusion decreased COP by 22% and surgery by 32%. The authors conclude that COP varies not only with gestational age but also with mode of delivery and experience of labor. In critically ill preterm neonates, because estimations form TP are inadequate, the only way to obtain a quantitative measure of COP is by direct measurement. Repeated measurements of COP will permit precise selection of the fluids and will warn of changes that may lead to pulmonary edema.
胶体渗透压（COP）是液体流动的重要调节因子，现在可以简单且可靠地进行测量。作者使用4100 Wescor胶体渗透压计来确定不同组新生儿的COP值及其与总蛋白浓度（TP）的关系。99名经阴道分娩的足月儿的平均COP为19.4±2.2（标准差）托，40名剖宫产的足月儿的平均COP为16.0±2.1（p<0.005）。未经历分娩而通过手术出生的婴儿的COP较低（14.9±1.8）。足月儿的COP与TP相关性良好（r = 0.92）。在60名患病早产儿中进行了362次测定，其COP（12.5±2.5）与足月儿不同（p<0.001），且与TP的相关性较差（r = 0.64）。发现不同的治疗方式对COP有广泛影响。输注晶体液使COP降低22%，手术使其降低32%。作者得出结论，COP不仅随胎龄变化，还随分娩方式和分娩经历而变化。在危重新生儿中，由于通过TP进行估算并不充分，获得COP定量测量的唯一方法是直接测量。重复测量COP将有助于精确选择液体，并警示可能导致肺水肿的变化。
