Plasma oncotic pressure and plasma protein concentration in patients following thermal injury

Plasma oncotic pressure (POP), albumin and total protein were measured in 14 patients with thermal injuries varying extent from 16 to 90% of the body surface. The patients were treated with large amounts of balanced salt solutions in the initial phase. There was an abrupt, pronounced decrease in POP to about 51% of the normal during the first 24 h. Despite the low POP values (minimum 0.78 kPa) and marked peripheral oedema, no patient had overt pulmonary oedema. Clinical and roentgenological evidence of pulmonary dysfunction during the initial period was only seen in conjunction with lung burn or aspiration pneumonitis. Oedema-preventing mechanism and inability to detect interstitial pulmonary oedema are discussed as possible explanations. There was no significant correlation between decrease in POP and mortality, but low POP values seemed to persist longer in the patients who died.