Critical care problems in neonates Colloid osmotic pressure in healthy and sick neonates

Bhat, Ravindra; Javed, Sidra; Malalis, Leonardo; Vidyasagar, D.

doi:10.1097/00003246-198108000-00001

Cited by 24 publications

(18 citation statements)

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“…The difference may be explained by the selection of lower weight and younger patients in our study. Bhat et al revealed that COP in critically ill preterm infants with hyaline membrane disease was 11.5 ± 1.2 mm Hg, which is similar to our study. Another study found that patients’ peri‐bypass COP was consistently lower than 15 mm Hg.…”

Section: Discussionsupporting

confidence: 92%

Effect of two different colloid priming strategies in infants weighing less than 5 kg undergoing on‐pump cardiac surgeries

et al. 2019

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Our aim was to explore the effect of two different priming strategies (artificial colloid only vs. artificial colloid combined with human serum albumin) on the prognosis of children weighing less than 5 kg undergoing on‐pump congenital heart disease (CHD) surgery. A total of 65 children weighing less than 5 kg who underwent on‐pump CHD surgery in our hospital from September 2016 to December 2017 were enrolled in this study. The children were randomly divided into two groups: artificial colloid priming group (AC group, n = 33) and artificial colloid combined albumin priming group (ACA group, n = 32). The primary clinical endpoint was the peri‐CPB colloid osmotic pressure (COP). Secondary clinical endpoints included perioperative blood product and hemostatic drug consumption, postoperative renal function, coagulation function, postoperative renal function, and postoperative recovery parameters. COP values were not significant in the priming system as well as peri‐CPB time points between the two groups (P > .05). Platelet consumption in the AC group was significantly lower than that in the ACA group (P < .05). There were no significant differences in the use of other blood products and hemostatic drugs as well as perioperative coagulation parameters between the two groups (P > .05). Postoperative length of stay in the AC group was significantly lower than that in the ACA group (P < .05). There were no significant differences in mortality, postoperative mechanical ventilation time, ICU time, and perioperative adverse events (including postoperative AKI) occurrences between the two groups (P > .05). In the on‐pump cardiac surgeries of patients weighing less than 5 kg, total colloidal priming would not affect peri‐CPB COP values, postoperative coagulation function, and blood products consumption. Total artificial colloidal priming strategy is feasible in low‐weight patients.

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Section: Discussionsupporting

confidence: 92%

Effect of two different colloid priming strategies in infants weighing less than 5 kg undergoing on‐pump cardiac surgeries

et al. 2019

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“…4 In newborn babies, a significant linear correlation between COP and total protein in cord blood has been described by Kero et al, 17 and even in sick neonates, COP is correlated with total protein during the first days of life, as reported by Bhat et al 18 In one previous investigation in newborn babies with RDS, we have described a significant positive correlation between COP, total protein and hypotension. 19 Based on all above, we can suppose that in our population protein levels reflected plasma volemia, and the decreased oncotic pressure could have impaired maintenance of intravascular volume and adequate blood flow to vital organs.…”

Section: Discussionsupporting

confidence: 74%

Hypoproteinemia on the first day of life and adverse outcome in very preterm infants admitted to the neonatal intensive care unit

et al. 2011

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Objective: We aimed to investigate the relationship between day-1 hypoproteinemia and severe adverse outcome (SAO) in very preterm infants admitted to the neonatal intensive care unit (NICU).Study Design: Retrospective study of all patients born from 24 to 31 weeks gestation and cared for in our NICU over an 8-year period. Infants were excluded if the serum protein value on the first day of life was not available.Result: A total of 913 patients were included. In all, 14.6% presented with SAO (death or severe neurological injury on cranial ultrasound). Hypoproteinemia (total protein level <40 g l À1 ) on day 1 of life occurred in 19.5 % of all patients. The rate of SAO was 33.7% in patients with hypoproteinemia and 9.9% in those with normoproteinemia (P<0.0001). Logistic and multiple regression analysis confirmed that the association hypoproteinemia-SAO remained significant after adjustment for the other major predictors of outcome present at baseline (odds ratio 3.4; 95% confidence interval 2.1-5.4; P<0.0001).Conclusion: Hypoproteinemia was highly associated with SAO in this cohort of critically ill preterm infants. We are unable to explain the link between hypoproteinemia and adverse outcome in our population. This investigation serves as a hypothesis-generating report of a large preterm infants sample, and suggests the need to assess the predictive accuracy for adverse outcome of hypoproteinemia in future prospective studies.

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“…We attribute these findings to the significant differences in colloid osmotic pressure over the course of the study (6). In the HES group, COP increased because the hydroxyethyl starch solution is hyperoncotic for young pigs as it is for infants with lower protein levels and an altered ratio of extracellular fluid volume to total body water compared with adults (7–9). Therefore, isooncotic synthetic colloid solutions for adults are hyperoncotic for infants (10) and the observed haemodilution in the HES group may be due to plasma volume expansion caused by transcapillary fluid shifts from the interstitial space into the intravascular space.…”

Section: Discussionmentioning

confidence: 99%

Haemodynamic, acid–base and electrolyte changes during plasma replacement with hydroxyethyl starch or crystalloid solution in young pigs

Sümpelmann

Schürholz

Marx

et al. 2000

Pediatric Anesthesia

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We investigated haemodynamic, acid-base and electrolyte changes during almost total plasma replacement with hydroxyethyl starch (HES) and physiological balanced electrolyte solution (PBE) by using a cell saver in ten young pigs. In the PBE group an additional 3550 (444) ml crystalloid solution [Mean (SD)] was infused over the course of the study in order to maintain pulmonary capillary wedge pressure. Plasma protein levels decreased in both groups and the colloid osmotic pressure increased in HES and decreased in PBE. At the end of the study, body weight [HES 10.4 (1), PBE 13.1 (1.4) kg, P < 0.01] and lactic acid concentration [HES 0.9 (0.3), PBE 2.9 (1. 3) mmol.l -1, P < 0.01] was higher and tissue oxygen delivery [HES 327 (22), PBE 89 (29) ml.min.m2, P < 0.01] was lower in the PBE group. There were only moderate acid-base changes in both groups, but at the end, anion gap was significant lower in HES. In conclusion, maintenance of colloid osmotic pressure close to the physiological range of infants seems to be advantageous during major paediatric surgery.

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Critical care problems in neonates Colloid osmotic pressure in healthy and sick neonates

Cited by 24 publications

References 0 publications

Effect of two different colloid priming strategies in infants weighing less than 5 kg undergoing on‐pump cardiac surgeries

Effect of two different colloid priming strategies in infants weighing less than 5 kg undergoing on‐pump cardiac surgeries

Hypoproteinemia on the first day of life and adverse outcome in very preterm infants admitted to the neonatal intensive care unit

Haemodynamic, acid–base and electrolyte changes during plasma replacement with hydroxyethyl starch or crystalloid solution in young pigs

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