Why the study?
Does the decrease in colloid osmotic pressure during cardiopulmonary bypass correlate with post-bypass pulmonary dysfunction in patients undergoing coronary artery bypass surgery?
Does the decrease in colloid osmotic pressure during cardiopulmonary bypass correlate with post-bypass pulmonary dysfunction in patients undergoing coronary artery bypass surgery?
Decreases in colloid osmotic pressure during routine, relatively short cardiopulmonary bypass are self-correcting and do not appear to cause post-perfusion pulmonary dysfunction.
Acute COP drop during CPB was unlinked to pulmonary dysfunction or edema; leaves open its role in prolonged or high-risk cases.
Determination of colloid osmotic pressure (COP), arterial blood gases (ABG) and weight were made in 25 consecutive patients undergoing cardiopulmonary bypass (CPB) with hemodilution. COP measurements were made prior to CPB, at 30 minute intervals during perfusion, and at 6, 12, 24 and 48 hours following CPB. Arterial blood gases were measured at 6, 12, 24 and 48 hours post-operatively. COP decreased abruptly with the initiation of bypass from 25.4 ± 3.4 mmHg to 16.8 ± 4.6 mmHg (p < 0.05) and remained at this level throughout the duration of bypass. All COPs returned to baseline levels, 23.6 ± 4.1 mmHg, 48 hours after surgery. Maximum decrease in COP was compared to the increase in calculated alveolar-arterial O2 gradient at 6, 12, 24 and 48 hours post-operative, and no significant correlation could be found. Similarly, the decrease in COP did not correlate with the weight gain present at 24 and 48 hours. COP is significantly altered by CPB and undoubtedly results in changes in fluid compartment dynamics. However, changes in COP do not seem to play a role in ventilatory problems following CPB in the routine patient.
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Wright et al. (1983) studied this question.
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