Plasma colloid osmotic pressure in healthy infants

Abstract

IntroductionPlasma COP is generated by the plasma proteins, particularly albumin, and is known to vary during various neonatal diseases [1][2][3][4]. Lower plasma COP favors a fluid shift from intravascular space into interstitial space, with subsequent formation of peripheral and pulmonary edema [3][4][5][6][7][8]. To stabilize the intravascular volume and prevent or reverse the events leading to peripheral and pulmonary edema, albumin or other colloid solutions are frequently administered, to maintain the COP in the 'normal' range [7][8][9][10][11][12]. Albumin administration for various conditions, however, is controversial [13][14][15]. Plasma COP in healthy neonates, sick neonates, and prematurely born infants are reported to be much lower than in adults [16][17][18]. The normal range of COP for healthy adults is reported to be between 22 and 28 mmHg, with a mean of 25 mmHg [19,20]. There is, however, no information in the literature on normal COP range beyond the early neonatal age. The adult COP values in our intensive care unit are also considered to be ANOVA = analysis of variance; COP = colloid osmotic pressure; SD = standard deviation. AbstractBackground The plasma colloid osmotic pressure (COP) plays a major role in transcapillary fluid balance. There is no information on plasma COP of healthy infants beyond the first post-natal week. The normal COP in healthy adult subjects (25 mmHg) is currently also applied as a reference value for healthy infants. This study was designed to test whether plasma COP values in healthy infants are the same as those in normal adults. Methods Plasma COP was measured in 37 male and female healthy infants from 1 to 11 months old. For this purpose, 1 ml blood was collected during the patient's regularly scheduled visit if the patient required any type of blood test for routine laboratory analyses. Results Plasma COP levels correlated slightly with increasing age from 1 to 9 months old (linear regression analysis; r 2 = 0.1, P < 0.049). We found no correlation between plasma COP and body weight at the same age (r 2 = 0.05, P = 0.155). The mean and standard deviation of COP in all infants was 25.1 ± 2.6 mmHg, which is almost identical to an average COP of 25 mmHg in healthy adult subjects. Arbitrary division of the infants into three different age groups (1-3 months [n = 11], 5-8 months [n = 13] and 9-11 months [n = 13]) showed an average increase of approximately 2 mmHg in COP of 9-month-old to 11-month-old infants, compared with 1-month-old to 3-month-old infants (one-way analysis of variance; P = 0.26). There was no gender difference in the COP level (unpaired t-test), with an average of 25.1 ± 2.4 mmHg in 19 male infants compared with 25.2 ± 2.9 in 18 female infants. The 95% confidence interval for COP in both male and female infants (n = 37) was between 24.3 to 26.0 mmHg, ranging from 19.5 to 30.3 mmHg, with a median value of 25.2 mmHg. Conclusions The data accept the null hypothesis that the COP range in infants younger than 1 year old is similar to those observed in ...

Assessing haemorrhage-critical values of cerebral blood flow by modelling biomechanical stresses on capillaries in the immature brain

“…1 a). For the infants from the control group with WG = 30 this pressure reached the value of = 2.5 kPa (19 mmHg), which is close to the mean value of blood colloid osmotic pressure of 23 mmHg measured for healthy infants one month old 24 . The shear stress (Fig.…”

Interstitial Fluid Colloid Osmotic Pressure in Healthy Children

“…COP p in healthy full-term (19.4 ± 2.2 mmHg) [ 23 ] and pre-term (15.4 ± 1.3 mmHg) [ 24 ] babies have been reported to be significantly lower than in healthy infants from 1 to 9 months of age [ 6 ], who may have values almost identical to that of adults (25 mmHg) [ 21 ]. Due to lack of data on changes in COP in infants up to 2 post-natal months, we anticipate a sharp increase in COP to occur within the first months of life.…”

“…In the case of interstitial colloid osmotic pressure (COP i ), this is likely due to lack of generally accepted methods for isolating IF. What is clear, however, is that plasma colloid osmotic pressure (COP p ) increases during the first months after birth, reaching at one year of age, values comparable to those reported in adult subjects [ 6 ]. Furthermore, decreased COP p in disease states, like congenital analbuminemia and during surgery for congenital cardiac malformations, is associated with compromised pulmonary function and tissue edema [ 7 , 8 ].…”

Transcapillary fluid flux and inflammatory response during neonatal therapeutic hypothermia: an open, longitudinal, observational study

“…Sick neonates, regardless of maturity, have an even more decreased COP p [ 15 , 24 , 25 ]. Sussmane et al showed that COP p in healthy infants from 1 to 11 months is in proportion to adult values, with an anticipated COP p increase during the first month of life [ 26 ]. Throughout TH treatment in the present study, the mean COP p (14.3 ± 2.6 mmHg) coincides with earlier observations of lowered plasma COP in sick newborns [ 15 ].…”