Priming of cardiopulmonary bypass with human albumin or Ringer lactate: effect on colloid osmotic pressure and extravascular lung water.
We have undertaken a randomized study on 20 patients undergoing coronary artery bypass surgery in order to determine the influence of cardiopulmonary pump prime solutions on colloid osmotic pressure and extravascular lung water. Crystalloid priming with Ringer lactate was compared with an albumin solution of nearly physiological colloid osmotic composition (4%). Measurements of extravascular lung water were performed by a modified, highly sensitive thermal dye technique, with additional detection of tracer signals in the pulmonary artery. In the Ringer lactate group, a significantly greater decrease in colloid osmotic pressure occurred immediately after onset of cardiopulmonary bypass. The more pronounced decrease in colloid osmotic pressure and in transcapillary gradient (difference between colloid osmotic pressure and pulmonary capillary wedge pressure) in the Ringer lactate group was associated with a significant increase in extravascular lung water (by 60%) in the postoperative period; the human albumin group, however, showed only a slight tendency to increased lung water. There were no differences in haemodynamic or respiratory states after operation.
Hoeft
A
A
Zentrum Anaesthesie, Rettungs- und Intensivmedizin der Universität Göttingen, Germany.
Korb
H
H
Mehlhorn
U
U
Stephan
H
H
Sonntag
H
H
D000418:Albumins / Q000494:pharmacology*; D002315:Cardiopulmonary Bypass; D003102:Colloids; D001026:Coronary Artery Bypass; D015633:Extravascular Lung Water / Q000187:drug effects*; D006801:Humans; D007552:Isotonic Solutions / Q000494:pharmacology*; D008875:Middle Aged; D009997:Osmotic Pressure; D000077325:Ringer's Lactate; D013997:Time Factors
D000418:Albumins; D003102:Colloids; D007552:Isotonic Solutions; D000077325:Ringer's Lactate