Fluid accumulation after closure of atrial septal defects: the role of colloid osmotic pressure
Abstract OBJECTIVES Following paediatric cardiac surgery with cardiopulmonary bypass (CPB), there is a tendency for fluid accumulation. The colloid osmotic pressure of plasma (COPp) and interstitial fluid (COPi) are determinants of transcapillary fluid exchange but only COPp has been measured in sic...
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| Veröffentlicht in: | Interactive cardiovascular and thoracic surgery 2018-02, Vol.26 (2), p.307-312 |
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| creator | Indrebø, Marianne Berg, Ansgar Holmstrøm, Henrik Seem, Egil Guthe, Hans Jørgen Wiig, Helge Norgård, Gunnar |
| description | Abstract
OBJECTIVES
Following paediatric cardiac surgery with cardiopulmonary bypass (CPB), there is a tendency for fluid accumulation. The colloid osmotic pressure of plasma (COPp) and interstitial fluid (COPi) are determinants of transcapillary fluid exchange but only COPp has been measured in sick children. The aim of this study was to assess the net colloid osmotic pressure gradient in children undergoing atrial septal defect closure.
METHODS
Twenty-three patients had interventional and 18 had surgical atrial septal defect closures. Interstitial fluid was harvested using a wick method before and after surgery with CPB with concomitant blood samples. COP was measured using a colloid osmometer for small fluid samples. Baseline COP was compared with data from healthy children.
RESULTS
COPp at baseline was 21.9 ± 2.8 and 21.4 ± 2.2 mmHg in the interventional and surgical groups, respectively, and was significantly lower than in healthy children (25.5 ± 3.1 mmHg) (P |
| doi_str_mv | 10.1093/icvts/ivx334 |
| format | Article |
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OBJECTIVES
Following paediatric cardiac surgery with cardiopulmonary bypass (CPB), there is a tendency for fluid accumulation. The colloid osmotic pressure of plasma (COPp) and interstitial fluid (COPi) are determinants of transcapillary fluid exchange but only COPp has been measured in sick children. The aim of this study was to assess the net colloid osmotic pressure gradient in children undergoing atrial septal defect closure.
METHODS
Twenty-three patients had interventional and 18 had surgical atrial septal defect closures. Interstitial fluid was harvested using a wick method before and after surgery with CPB with concomitant blood samples. COP was measured using a colloid osmometer for small fluid samples. Baseline COP was compared with data from healthy children.
RESULTS
COPp at baseline was 21.9 ± 2.8 and 21.4 ± 2.2 mmHg in the interventional and surgical groups, respectively, and was significantly lower than in healthy children (25.5 ± 3.1 mmHg) (P < 0.001). In the surgical group, the use of CPB significantly reduced COPp to 16.9 ± 2.9 mmHg (P < 0.001) and the colloid osmotic gradient [ΔCOP (COPp − COPi)] to 2.9 ± 3.8 mmHg (P < 0.001) compared with interventional procedure. One hour after the procedure, COPi was 15.6 ± 3.8 mmHg and 9.9 ± 2.1 mmHg (P < 0.001) and the ΔCOP was 5.4 ± 3.0 mmHg and 9.1 ± 3.1 mmHg (P < 0.003) in the interventional and surgical groups, respectively.
CONCLUSIONS
Baseline COPp and COPi were lower in atrial septal defect patients compared with healthy children. The significantly lower COP gradient during CPB may explain the tendency for more fluid accumulation with pericardial effusion in the surgical group. The increased COP gradient after CPB may represent an oedema-preventive mechanism.</description><identifier>ISSN: 1569-9293</identifier><identifier>EISSN: 1569-9285</identifier><identifier>DOI: 10.1093/icvts/ivx334</identifier><identifier>PMID: 29049836</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Cardiac Surgical Procedures - adverse effects ; Child, Preschool ; Colloids - chemistry ; Cross-Sectional Studies ; Echocardiography ; Edema - diagnosis ; Edema - etiology ; Edema - metabolism ; Female ; Heart Septal Defects, Atrial - diagnosis ; Heart Septal Defects, Atrial - physiopathology ; Heart Septal Defects, Atrial - surgery ; Humans ; Male ; Osmotic Pressure ; Postoperative Complications ; Prospective Studies</subject><ispartof>Interactive cardiovascular and thoracic surgery, 2018-02, Vol.26 (2), p.307-312</ispartof><rights>The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. 2017</rights><rights>The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c361t-34d4b733ea8bb40203915347da3bcbc98eda90ffbbf4387e2e51120c797a93a03</citedby><cites>FETCH-LOGICAL-c361t-34d4b733ea8bb40203915347da3bcbc98eda90ffbbf4387e2e51120c797a93a03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1598,27901,27902</link.rule.ids><linktorsrc>$$Uhttps://dx.doi.org/10.1093/icvts/ivx334$$EView_record_in_Oxford_University_Press$$FView_record_in_$$GOxford_University_Press</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29049836$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Indrebø, Marianne</creatorcontrib><creatorcontrib>Berg, Ansgar</creatorcontrib><creatorcontrib>Holmstrøm, Henrik</creatorcontrib><creatorcontrib>Seem, Egil</creatorcontrib><creatorcontrib>Guthe, Hans Jørgen</creatorcontrib><creatorcontrib>Wiig, Helge</creatorcontrib><creatorcontrib>Norgård, Gunnar</creatorcontrib><title>Fluid accumulation after closure of atrial septal defects: the role of colloid osmotic pressure</title><title>Interactive cardiovascular and thoracic surgery</title><addtitle>Interact Cardiovasc Thorac Surg</addtitle><description>Abstract
OBJECTIVES
Following paediatric cardiac surgery with cardiopulmonary bypass (CPB), there is a tendency for fluid accumulation. The colloid osmotic pressure of plasma (COPp) and interstitial fluid (COPi) are determinants of transcapillary fluid exchange but only COPp has been measured in sick children. The aim of this study was to assess the net colloid osmotic pressure gradient in children undergoing atrial septal defect closure.
METHODS
Twenty-three patients had interventional and 18 had surgical atrial septal defect closures. Interstitial fluid was harvested using a wick method before and after surgery with CPB with concomitant blood samples. COP was measured using a colloid osmometer for small fluid samples. Baseline COP was compared with data from healthy children.
RESULTS
COPp at baseline was 21.9 ± 2.8 and 21.4 ± 2.2 mmHg in the interventional and surgical groups, respectively, and was significantly lower than in healthy children (25.5 ± 3.1 mmHg) (P < 0.001). In the surgical group, the use of CPB significantly reduced COPp to 16.9 ± 2.9 mmHg (P < 0.001) and the colloid osmotic gradient [ΔCOP (COPp − COPi)] to 2.9 ± 3.8 mmHg (P < 0.001) compared with interventional procedure. One hour after the procedure, COPi was 15.6 ± 3.8 mmHg and 9.9 ± 2.1 mmHg (P < 0.001) and the ΔCOP was 5.4 ± 3.0 mmHg and 9.1 ± 3.1 mmHg (P < 0.003) in the interventional and surgical groups, respectively.
CONCLUSIONS
Baseline COPp and COPi were lower in atrial septal defect patients compared with healthy children. The significantly lower COP gradient during CPB may explain the tendency for more fluid accumulation with pericardial effusion in the surgical group. The increased COP gradient after CPB may represent an oedema-preventive mechanism.</description><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Child, Preschool</subject><subject>Colloids - chemistry</subject><subject>Cross-Sectional Studies</subject><subject>Echocardiography</subject><subject>Edema - diagnosis</subject><subject>Edema - etiology</subject><subject>Edema - metabolism</subject><subject>Female</subject><subject>Heart Septal Defects, Atrial - diagnosis</subject><subject>Heart Septal Defects, Atrial - physiopathology</subject><subject>Heart Septal Defects, Atrial - surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Osmotic Pressure</subject><subject>Postoperative Complications</subject><subject>Prospective Studies</subject><issn>1569-9293</issn><issn>1569-9285</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kL1PwzAQRy0EoqWwMSNvMBBq55wPs6GKAlIlFpgjx7mIIKcOtlPBf0_alI5MvxveveERcsnZHWcS5o3eBD9vNt8A4ohMeZLKSMZ5cny4JUzImfefjHHJgJ2SSSyZkDmkU1IsTd9UVGndt71RobFrquqAjmpjfe-Q2pqq4BplqMcuDFNhjTr4exo-kDprdoi2xthBZH1rQ6Np59Bv38_JSa2Mx4v9zsj78vFt8RytXp9eFg-rSEPKQwSiEmUGgCovS8FiBpInILJKQalLLXOslGR1XZa1gDzDGBPOY6YzmSkJisGM3IzeztmvHn0o2sZrNEat0fa-4DIRLBUc0gG9HVHtrPcO66JzTavcT8FZsU1a7JIWY9IBv9qb-7LF6gD_NRyA6xGwffe_6hfICoK7</recordid><startdate>20180201</startdate><enddate>20180201</enddate><creator>Indrebø, Marianne</creator><creator>Berg, Ansgar</creator><creator>Holmstrøm, Henrik</creator><creator>Seem, Egil</creator><creator>Guthe, Hans Jørgen</creator><creator>Wiig, Helge</creator><creator>Norgård, Gunnar</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20180201</creationdate><title>Fluid accumulation after closure of atrial septal defects: the role of colloid osmotic pressure</title><author>Indrebø, Marianne ; Berg, Ansgar ; Holmstrøm, Henrik ; Seem, Egil ; Guthe, Hans Jørgen ; Wiig, Helge ; Norgård, Gunnar</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c361t-34d4b733ea8bb40203915347da3bcbc98eda90ffbbf4387e2e51120c797a93a03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Child, Preschool</topic><topic>Colloids - chemistry</topic><topic>Cross-Sectional Studies</topic><topic>Echocardiography</topic><topic>Edema - diagnosis</topic><topic>Edema - etiology</topic><topic>Edema - metabolism</topic><topic>Female</topic><topic>Heart Septal Defects, Atrial - diagnosis</topic><topic>Heart Septal Defects, Atrial - physiopathology</topic><topic>Heart Septal Defects, Atrial - surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Osmotic Pressure</topic><topic>Postoperative Complications</topic><topic>Prospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Indrebø, Marianne</creatorcontrib><creatorcontrib>Berg, Ansgar</creatorcontrib><creatorcontrib>Holmstrøm, Henrik</creatorcontrib><creatorcontrib>Seem, Egil</creatorcontrib><creatorcontrib>Guthe, Hans Jørgen</creatorcontrib><creatorcontrib>Wiig, Helge</creatorcontrib><creatorcontrib>Norgård, Gunnar</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Interactive cardiovascular and thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Indrebø, Marianne</au><au>Berg, Ansgar</au><au>Holmstrøm, Henrik</au><au>Seem, Egil</au><au>Guthe, Hans Jørgen</au><au>Wiig, Helge</au><au>Norgård, Gunnar</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fluid accumulation after closure of atrial septal defects: the role of colloid osmotic pressure</atitle><jtitle>Interactive cardiovascular and thoracic surgery</jtitle><addtitle>Interact Cardiovasc Thorac Surg</addtitle><date>2018-02-01</date><risdate>2018</risdate><volume>26</volume><issue>2</issue><spage>307</spage><epage>312</epage><pages>307-312</pages><issn>1569-9293</issn><eissn>1569-9285</eissn><abstract>Abstract
OBJECTIVES
Following paediatric cardiac surgery with cardiopulmonary bypass (CPB), there is a tendency for fluid accumulation. The colloid osmotic pressure of plasma (COPp) and interstitial fluid (COPi) are determinants of transcapillary fluid exchange but only COPp has been measured in sick children. The aim of this study was to assess the net colloid osmotic pressure gradient in children undergoing atrial septal defect closure.
METHODS
Twenty-three patients had interventional and 18 had surgical atrial septal defect closures. Interstitial fluid was harvested using a wick method before and after surgery with CPB with concomitant blood samples. COP was measured using a colloid osmometer for small fluid samples. Baseline COP was compared with data from healthy children.
RESULTS
COPp at baseline was 21.9 ± 2.8 and 21.4 ± 2.2 mmHg in the interventional and surgical groups, respectively, and was significantly lower than in healthy children (25.5 ± 3.1 mmHg) (P < 0.001). In the surgical group, the use of CPB significantly reduced COPp to 16.9 ± 2.9 mmHg (P < 0.001) and the colloid osmotic gradient [ΔCOP (COPp − COPi)] to 2.9 ± 3.8 mmHg (P < 0.001) compared with interventional procedure. One hour after the procedure, COPi was 15.6 ± 3.8 mmHg and 9.9 ± 2.1 mmHg (P < 0.001) and the ΔCOP was 5.4 ± 3.0 mmHg and 9.1 ± 3.1 mmHg (P < 0.003) in the interventional and surgical groups, respectively.
CONCLUSIONS
Baseline COPp and COPi were lower in atrial septal defect patients compared with healthy children. The significantly lower COP gradient during CPB may explain the tendency for more fluid accumulation with pericardial effusion in the surgical group. The increased COP gradient after CPB may represent an oedema-preventive mechanism.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>29049836</pmid><doi>10.1093/icvts/ivx334</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Cardiac Surgical Procedures - adverse effects Child, Preschool Colloids - chemistry Cross-Sectional Studies Echocardiography Edema - diagnosis Edema - etiology Edema - metabolism Female Heart Septal Defects, Atrial - diagnosis Heart Septal Defects, Atrial - physiopathology Heart Septal Defects, Atrial - surgery Humans Male Osmotic Pressure Postoperative Complications Prospective Studies |
| title | Fluid accumulation after closure of atrial septal defects: the role of colloid osmotic pressure |
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