COLLOID ONCOTIC PRESSURE AND LEVELS OF ALBUMIN AND TOTAL PROTEIN DURING MAJOR SURGICAL PROCEDURES

  • 1 January 1976
    • journal article
    • research article
    • Vol. 143  (4) , 592-596
Abstract
Whole blood alone or red blood cells reconstituted with saline solution do not adequately replace the loss of albumin and concomitant decrease in colloid oncotic pressure that occur during extensive intraabdominal and intrathoracic operations. Since colloid oncotic pressure is a major factor in the restitution of intravascular volume from stores of interstitial fluid and since it may also play a role in the development of postoperative pulmonary problems, it is important to maintain a relatively normal colloid oncotic pressure during the operation and in the immediate postoperative period. Although dextran can be used for this purpose, its short half-life of 4-6 h and associated coagulation problems militate against its use in large quantities. This leaves purified protein fraction or salt-poor albumin as the main sources of protein for the maintenance of colloid oncotic pressure. Both of these products are expensive and short in supply. The oncometer in present use is a clinically feasible and rapid, 1-3 min, means of determining the colloid oncotic pressure. It permits a rational approach to the use of albumin products, avoiding the pitfalls of under or excess administration in the operative and postoperative periods.

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