Herz
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With regard to Starling's equation, two factors are important for fluid regulation in pulmonary tissue: colloid osmotic pressure (COP) and hydrostatic pressure (PCP). The purpose of the study was to evaluate the relationship between COP, COP-PCP-gradient and extravascular lung water (EVLW) immediately after extracorporeal circulation (ECC). 39 consenting patients undergoing elective aorto-coronary bypass surgery received 1000 ml washed erythrocytes (w.e.; cell saver) +400 ml fresh frozen plasma (FFP) after ECC. Additionally, group I (n = 15) received 300 ml albumin 20%, group II (n = 13) 500 ml plasmaexpander (3% HES 200/0.5) and group III (n = 11) no more volume. ⋯ No correlation between EVLW and COP-PCP-gradient could be observed. In spite of a significant elevation of COP by using 20% albumin solution, EVLW increased with subsequent deterioration of pulmonary gas exchange. The presented data demonstrate no advantage of albumin 20%; if volume substitution is necessary after ECC, low concentrated plasmaexpanders (up to 10 ml/kg b.w.) may be preferred for several reasons.