Chest
Clinical InvestigationsColloid Osmotic Pressure as a Prognostic Indicator of Pulmonary Edema and Mortality in the Critically Ill
Section snippets
MATERIALS AND METHODS
The study included 128 consecutive admissions to the Kings County Hospital critical care unit from January, 1976 through Mardi, 1976. The patient population was composed of 67 men and 61 women whose ages ranged from 15 to 94 (median = 64). Eighty-six patients survived to leave the hospital and 42 expired. The primary diagnoses are summarized in Table 1.
Central venous blood samples were taken from each patient for total protein, albumin, and serum colloid osmotic pressure (COP) determinations
RESULTS
The mean COP of all 128 critically ill patients was 20.4 (± 0.4 SEM) mm Hg (Fig 1). This was significantly lower than that of our normal subjects (P < 0.001). The critically ill patients were divided into three groups on the basis of chest roentgenograms, clinical diagnosis, and PWP when available: no pulmonary edema (NPE); cardiogenic pulmonary edema (CPE); and noncardiogenic pulmonary edema (NCPE) (Table 2). The mean grade of pulmonary edema on chest roentgenograms was 3.2 (± 0.1 SEM) in both
DISCUSSION
The Starling fluid transport equation1 describes the net flux of fluid across a capillary membrane under steady state conditions: where K is the filtration coefficient in milliliters per second per centimeter2 per mm Hg, Pc is the capillary hydrostatic pressure in mm Hg (ie, PWP), π1 is the osmotic pressure of interstitial protein in mm Hg, P1 is the interstitial hydrostatic pressure in mm Hg, and πe is the osmotic pressure of plasma protein in mm Hg (ie, COP). The
ACKNOWLEDGMENTS
We wish to thank Mitchell Horowitz, Anthony Babich, Sylvia Berman and the medical housestaff of the Kings County Hospital Center for their contributions to this study.
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Manuscript received January 21; revision accepted April 6.