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Interstitial hydrostatic pressures in patients undergoing CABG and valve replacement
The Journal of Thoracic and Cardiovascular Surgery
|February 1, 1980
Summary
Interstitial fluid hydrostatic pressure (IFP) in thigh muscle rises more than in subcutaneous tissue during cardiopulmonary bypass. Muscle tissue has tighter, less compliant interstitial spaces compared to subcutaneous tissue.
Area of Science:
- Cardiovascular Physiology
- Biomedical Engineering
Background:
- Cardiopulmonary bypass (CPB) involves complex fluid shifts.
- Understanding interstitial fluid hydrostatic pressure (IFP) is crucial for managing fluid balance during CPB.
Purpose of the Study:
- To investigate the differences in interstitial fluid hydrostatic pressure (IFP) between thigh muscle (MIP) and subcutaneous tissue (SQIP) in patients undergoing CPB.
- To correlate IFP changes with serum total proteins (TP) and colloid osmotic pressure (COP).
Main Methods:
- Utilized the Scholander-Hargens wick technique for simultaneous IFP measurements in thigh muscle and subcutaneous tissue.
- Monitored serum total proteins (TP) and colloid osmotic pressure (COP) throughout the CPB procedure.
Main Results:
- Muscle IFP (MIP) demonstrated a greater increase during hemodilution compared to subcutaneous IFP (SQIP).
- MIP remained less negative than SQIP throughout the study period.
- MIP exhibited a faster rise in response to decreases in COP than SQIP.
Conclusions:
- Subcutaneous tissue exhibits a loose, high-compliance interstitial space, while muscle tissue has a tight, low-compliance interstitial space.
- CPB-induced fluid shifts lead to increased muscle IFP, which is resolved upon restoration of COP.
- Animal studies indicate similar IFP responses in the myocardium.