Hemodynamic and colloid osmotic pressure alterations in the surgical patient.

Colloid osmotic pressure (COP) was measured simultaneously with cardiorespiratory measurements in 103 surgical patients suspected of having circulatory problems. In a small subset of 28 patients, measurements were taken before, during, and after surgical operations. Similarly, data sets were taken before, during, and after infusions of colloids and crystalloids to assess the interactions of these variables during the stress of surgery and the administration of fluid therapy. COP was found to decrease during and shortly after surgical operations despite reasonably well-maintained pressure, volume, and flow variables. Concentrated (25%) albumin and plasma protein fraction (PPF) increased COP, cardiac index (CI), CVP, pulmonary capillary wedge pressure (WP), and blood volume, whereas crystalloids transiently increased CI, CVP, and WP but did not significantly change COP and blood volume. Low COP values were weakly related to survival, and COP-WP differences less than or equal to 3 mm Hg were roughly related to ARDS and pulmonary edema.