Effects of Advanced Age on Extravascular Lung Water Accumulation During Coronary Artery Bypass Surgery

Priming of Cardiopulmonary Bypass With Human Albumin or Ringer Lactate: Effect on Colloid Osmotic Pressure and Extravascular Lung Water

“…In the HA gToup there was only a slight tendency to accumulation of extravascular lung water. Although the calculated albumin content of the priming volume was 4 % and therefore considerably greater than that used in all previous investigations [11][12][13][14][15], a slight decrease in colloid osmotic pressure was found in this group. In the RL group, the decrease in colloid osmotic pressure was much more pronounced and was accompanied by a marked increase in extravascular lung water.…”

“…After induction of anaesthesia, a specially designed balloon-tipped catheter with an additional fibreoptic lead for intravascular dye measurements was placed into the pulmonary Conventionally, measurement of extravascular lung water is based on calculation of mean transit times for dye and heat from aortic dilution curves. This is possible only after elimination of indicator recirculation by monoexponential extrapolation [11][12][13][14][15][16]. This approach involves assumptions that have not been verified [19] and have been shown in animal experiments to bear a systematic additive error and possess limited accuracy [18].…”

“…merit and therefore should be maintained in the physiological range, in particular when capillary permeability is increased [10]. However, with the onset of cardiopulmonary bypass, the plasma is diluted by the prime volume of the machine and colloid osmotic pressure may decrease considerably, depending on the composition of the priming solution [1,2,6,[11][12][13][14]. Addition of colloids to the pump prime solution has been advocated, therefore, by several groups.…”

“…Addition of colloids to the pump prime solution has been advocated, therefore, by several groups. However, in most studies the added amounts of albumin or hydroxyethyl starch were not sufficient to result in a physiological colloid osmotic pressure in the prime solutions [1,[11][12][13][14]. Furthermore, the results on postoperative accumulation of extravascular lung water were controversial: while some studies failed to show an increase in lung water [12], others demonstrated a significant increase in lung water at different times after operation [13,15,16].…”

Fluid and Electrolyte Therapy in Cardiac Surgery

“…Bu nedenle de postoperatif hipoksi durumlarında EVLW miktarındaki artmanın sorumlu tutulmasının ve bu amaçla sıvı kısıtlaması ve diüretik yapı-mının sorgulanması gerektiği belirtilmektedir. Özellikle araştırılırsa tüm KPB uygulaması sonrası EVLW miktarında artma olduğu, buna paralel olarak intratorasik kan volümünde (ITBV) de artış olduğu ve bu artışın postop 20. saate kadarda sürdüğü tespit edilmiştir (47) . EVLW ile ITBV ve gaz değişim değerleri arasında bir korelasyon yoktur (48) .…”