Abstract
The clinical significance of colloid osmotic pressure (COP) in transcapillary fluid exchange and water homeostasis in health and disease is described. Under pathophysiological circumstances measurement of COP should be preferred to COP value calculation. After extensive COP experiences in critically ill adults and numerous refinements in COP monitoring technology, COP studies in neonates and paediatric intensive care patients have been published recently. In these patients hypovolaemia and need of volume replacement therapy are often associated with an increase in capillary permeability. Therefore prevention of general and interstitial colloid and fluid overload is a permanent challenge in the care of the young critically ill patient; e.g. in a case report. Consequently regular COP measurements should be considered in paediatric intensive care, especially in case of oncotic volume replacement therapy.

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