PMID- 6845168
OWN - NLM
STAT- MEDLINE
DCOM- 19830610
LR  - 20201209
IS  - 0039-6060 (Print)
IS  - 0039-6060 (Linking)
VI  - 93
IP  - 5
DP  - 1983 May
TI  - The short-term effects of increasing plasma colloid osmotic pressure in patients 
      with noncardiac pulmonary edema.
PG  - 620-33
AB  - We infused hyperoncotic albumin (25 or 50 gm of a 50% solution) into patients 
      with noncardiac pulmonary edema (adult respiratory distress syndrome [ARDS]) to 
      evaluate its effect on the transmicrovascular flux from blood to pulmonary edema 
      fluid of two radiotracers--111In-DTPA (mol wt 504) and 125I-human serum albumin 
      (HSA) (mol wt 69,000). Two groups of patients were studied--one with a modest 
      increase in permeability of the pulmonary alveolocapillary membrane to 125I-HSA 
      (group 1) and another with a large increase in permeability to 125I-HSA (group 
      2). We used furosemide, when necessary, to minimize the effect of albumin 
      infusion to increase the pulmonary microvascular hydrostatic pressure (Pmv), 
      measured clinically as the pulmonary capillary wedge pressure (PCWP). Therapy 
      significantly increased the mean colloid osmotic pressure (COP) in both groups, 
      but not the mean PCWP or calculated Pmv. Albumin had no significant effect on the 
      mean pulmonary transmicrovascular flux of the radiotracers in either group, 
      despite the increase in COP. In individual patients, a change in the Pmv in 
      response to albumin infusion was directly correlated with the change in flux of 
      111In-DTPA [group 1: delta In-DTPA (%) = 8.66 + 1.4 delta Pmv (%) r = 0.51, P 
      less than 0.02; group 2: delta In-DTPA (%) = -3.43 + 1.6 delta Pmv (%) r = 0.67, 
      P less than 0.01]. A change in the transmicrovascular flux of I-HSA also 
      correlated with a change in the intravascular Starling forces in both groups. We 
      conclude that albumin infusion in patients with ARDS will not augment the 
      pulmonary transmicrovascular flux of low or high molecular-weight solutes when 
      the effect of albumin to increase the Pmv is minimized; nor, however, does an 
      increase in plasma COP significantly reduce the flux of such solutes.
FAU - Sibbald, W J
AU  - Sibbald WJ
FAU - Driedger, A A
AU  - Driedger AA
FAU - Wells, G A
AU  - Wells GA
FAU - Myers, M L
AU  - Myers ML
FAU - Lefcoe, M
AU  - Lefcoe M
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Surgery
JT  - Surgery
JID - 0417347
RN  - 0 (Albumins)
RN  - 0 (Colloids)
RN  - 0 (Radioisotopes)
RN  - 0 (Serum Albumin, Radio-Iodinated)
RN  - 045A6V3VFX (Indium)
RN  - 7A314HQM0I (Pentetic Acid)
SB  - IM
MH  - Albumins/*therapeutic use
MH  - Capillary Permeability/*drug effects
MH  - Colloids
MH  - Humans
MH  - Hydrostatic Pressure
MH  - Indium
MH  - Osmotic Pressure
MH  - Pentetic Acid
MH  - Pulmonary Edema/*physiopathology
MH  - Pulmonary Wedge Pressure/drug effects
MH  - Radioisotopes
MH  - Respiratory Distress Syndrome/*physiopathology
MH  - Serum Albumin, Radio-Iodinated
EDAT- 1983/05/01 00:00
MHDA- 1983/05/01 00:01
CRDT- 1983/05/01 00:00
PHST- 1983/05/01 00:00 [pubmed]
PHST- 1983/05/01 00:01 [medline]
PHST- 1983/05/01 00:00 [entrez]
AID - 0039-6060(83)90260-X [pii]
PST - ppublish
SO  - Surgery. 1983 May;93(5):620-33.