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Related Experiment Videos

Does reduced colloid oncotic pressure increase pulmonary dysfunction in sepsis?

J P Kohler, C L Rice, C K Zarins

    Critical Care Medicine
    |February 1, 1981
    PubMed
    Summary

    Sepsis causes pulmonary dysfunction, but this effect is not linked to changes in colloid oncotic pressure (COP) or pulmonary artery wedge (PAW) pressure. Reduced COP alone did not cause pulmonary edema in septic baboons.

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    Area of Science:

    • Physiology
    • Pathophysiology
    • Critical Care Medicine

    Background:

    • Starling's hypothesis explains fluid movement across capillaries based on oncotic pressure and permeability.
    • Decreased intracapillary colloid oncotic pressure (COP) or increased capillary permeability typically leads to increased interstitial fluid.
    • Sepsis is a common cause of clinical pulmonary dysfunction, prompting investigation into its relationship with COP and pulmonary artery wedge (PAW) pressure.

    Purpose of the Study:

    • To investigate whether a reduced COP-PAW gradient in the presence of sepsis increases pulmonary dysfunction.
    • To determine if sepsis-induced pulmonary dysfunction is dependent on colloid oncotic forces.

    Main Methods:

    • Twenty baboons were divided into four groups: control, sepsis (E. coli infusion), plasmapheresis alone, and plasmapheresis followed by sepsis.

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  • Pulmonary artery wedge (PAW) pressure was kept constant using Ringer's lactate infusion.
  • Arterial and mixed venous blood gases were analyzed to calculate the intrapulmonary shunt (QS/QT).
  • Statistical analysis included Tukey's HSD test and one-way analysis of variance.

    • Main Results:

    • Plasmapheresis significantly reduced COP by 68% in both plasmapheresis groups.
    • Sepsis increased the intrapulmonary shunt (QS/QT) in all septic animals.
    • Animals subjected to plasmapheresis followed by sepsis (group 4) did not show an increased QS/QT compared to controls, despite reduced COP.

    Conclusions:

    • Sepsis independently leads to pulmonary dysfunction.
    • The pulmonary dysfunction observed in sepsis appears to be independent of colloid oncotic forces.
    • Reduced COP alone, even in the context of sepsis, does not appear to cause pulmonary interstitial edema.