The direct measurement of plasma colloid osmotic pressure is superior to colloid osmotic pressure derived from albumin or total protein

1987 ◽  
Vol 13 (2) ◽  
Author(s):  
S.A. Barclay ◽  
D. Bennett
Keyword(s):  
Osmotic Pressure ◽  
Direct Measurement ◽  
Total Protein ◽  
Colloid Osmotic Pressure

Impact of modifying priming components and fluid administration using miniaturized circuitry in neonatal cardiopulmonary bypass

Perfusion ◽  
2000 ◽  
Vol 15 (1) ◽  
pp. 3-12 ◽  
Author(s):  
Edward Darling ◽  
Sandra Harris-Holloway ◽  
Frank H Kern ◽  
Ross Ungerleider ◽  
James Jaggers ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Initial Data ◽  
Osmotic Pressure ◽  
Total Protein ◽  
Laboratory Tests ◽  
Colloid Osmotic Pressure ◽  
Ionized Calcium ◽  
Oncotic Pressure ◽  
Group 2 ◽  
Group 1

Following a succession of changes in circuitry and priming additives between 1993 and 1998, a comprehensive re-evaluation of neonatal cardiopulmonary bypass (CPB) practice was undertaken. Samples from 10 infants (Group 1) undergoing CPB were evaluated for osmolality, oncotic pressure, total protein, hematocrit, glucose, and electrolytes (Na+, K+, iCa2+). These samples were tested at six measurement points: (1) after priming, (2) patient pre-CPB, (3) CPB-start, (4) CPB-mid, (5) CPB-end, and (6) post-modified ultrafiltration (MUF). Prime volumes were also carefully measured as well as the type and amount of volume given during CPB. After evaluating the initial data, changes in protocol regarding mannitol, calcium correction, and oncotic strength on CPB were made. Following implementation of these protocol changes, a second set (Group 2) of 10 infants was identically evaluated. Group 1 prime osmolality was 379 ± 44 mOsm/kg, while Group 2 prime osmolality was 324 ± 14 mOsm/kg ( p = 0.003). There were no differences in osmolality between groups during bypass and osmolality was unaffected by modified ultrafiltration. Ionized calcium levels were significantly different at the end of bypass between Group 1, 0.6 ± 0.1 mmol/l; and Group 2, 1.17 ± 0.24 mmol/l ( p < 0.001). In Group 1, there was a 40% drop ( p = 0.001) in colloid osmotic pressure (COP) levels from pre-CPB (13.3 ± 3.4 mmHg) to CPB-end (8.8 ± 1.2 mmHg). In Group 2, there were no differences in COP during CPB. COP levels of Group 1 and Group 2 at CPB-end were 8.8 ± 1.2 mmHg and 14 ± 1.9, respectively ( p < 0.0001). Total volume addition during bypass for Group 1 was 363.5 ± 148.7 ml and for Group 2 was 245.1 ± 92.2 ml ( p < 0.05). In conclusion, progressive changes in neonatal circuits and techniques can have potentially wide-ranging effects on electrolyte and osmotic/oncotic homeostasis. An audit of perfusion management through expanded laboratory tests is recommended, especially in periods of change.

scholarly journals Serum Albumin by Dye-Binding: Bromocresol Green or Bromocresol Purple? The Case for Conservatism

1988 ◽  
Vol 25 (4) ◽  
pp. 417-421 ◽  
Author(s):  
Jean M McGinlay ◽  
R B Payne
Keyword(s):  
Osmotic Pressure ◽  
Incubation Time ◽  
Total Protein ◽  
Correlation Coefficients ◽  
Colloid Osmotic Pressure ◽  
Bromocresol Green ◽  
Bromocresol Purple ◽  
Wide Range ◽  
Calcium And Magnesium ◽  
Short Incubation Time

Pooled patient's serum selected to have a wide range of albumin concentrations was analysed for albumin by bromocresol green with both long and short incubation times and also by bromocresol purple. Total protein, colloid osmotic pressure, calcium and magnesium were also measured. There were strong linear correlations between albumin measured by the three methods. Albumin values by bromocresol green with a short incubation time (1·5 min) averaged 5 g/L higher than those by bromocresol purple at all albumin concentrations. Colloid osmotic pressure correlated less strongly with total protein and with albumin by bromocresol purple than with albumin by the two bromocresol green methods. There were no significant differences between the correlation coefficients of calcium or magnesium with total protein and with albumin measured by the three methods. Bromocresol purple has no advantage over bromocresol green with a short incubation time for the clinical purposes for which albumin is measured: to detect abnormality, monitor change, predict colloid osmotic pressure and adjust calcium and magnesium for abnormal protein concentrations.

Relationship between colloid osmotic pressure and plasma protein concentration in the dog

1977 ◽  
Vol 233 (2) ◽  
pp. H295-H298 ◽  
Author(s):  
P. D. Navar ◽  
L. G. Navar
Keyword(s):  
Osmotic Pressure ◽  
Total Protein ◽  
Protein Concentration ◽  
Colloid Osmotic Pressure ◽  
Plasma Samples ◽  
Total Protein Concentration ◽  
Plasma Protein Concentration ◽  
Dog Plasma ◽  
The Relationship ◽  
Pressure Analysis

This study was done to establish the correct relationship between protein concentration and plasma colloid osmotic pressure in the dog and to determine the possible influence of the relative albumin and globulin content (A:G ratio). Plasma samples from dogs, rats, and humans were evaluated for total protein concentration, globulin concentration, and colloid osmotic pressure. Samples were concentrated and diluted by ultrafiltration to provide a range of total protein concentrations from 1 to 12 g/dl. Rat and human plasma samples had A:G ratios of 1.4 and 2.1, respectively, and the relationship between protein concentration and colloid osmotic pressure was in agreement with the Landis-Pappenheimer equation. In contrast, dog plasma samples consistently exhibited lower colloid osmotic pressures for any given protein concentration. Two forms of empirical equations were derived to relate these parameters in the dog. Dog plasma samples had higher concentrations of globulin and the A:G ratio averaged 0.59 +/- 0.35 SD. There was a significant relationship between the A:G ratio and the plasma colloid osmotic pressure. Analysis of the possible effect of this altered relationship on glomerular filtration dynamics predicted that efferent plasma colloid osmotic pressure was not specifically affected and was dependent only on the filtration fraction and the plasma colloid osmotic pressure.

Sign in / Sign up

Export Citation Format

Share Document