According to Starling principles, the plasma COP is one of the major factors affecting fluid flux across the capillaries. However, the role of COP in modulating the fluid flux across the capillary membrane in critically ill patients is controversial. Two reviews’ concluded that albumin-treated patients have a 4 to 6% excess mortality rate compared to crystalloid-treated patients. In contrast, Choi et al have concluded that there is no difference in mortality rate between the crystalloid-treated patients and the colloid-treated patients. Concerning fluid flux in individual organs, increasing COP during normo-thermic cardioplegia can minimize myocardial edema. In a rat model, Belayev et al demonstrated that a high dose of albumin therapy, 5 min after creating global cerebral ischemia, significantly improved the neurologic scores and reduced histologic changes. During sepsis, however, an increase in the capillary permeability is generalized. The complex factors of fluid transport across the membrane with capillary leakage and decreased COP, as well as the design of different studies, are the major factors that prevent studies to reach conclusive clinical guidelines for fluid resuscitation. canadian-familypharmacy.com
In the present study, we utilized a rat model in which gas-exchange efficiency and hemodynamic stability were measured under strictly controlled anesthesia, with variable environmental condi-tions.” We also tried to eliminate confounding factors that may complicate the outcome, such as the administration of different volumes of fluids in different groups to achieve a “normal” end point. Our hypothesis is that an increase in blood COP that is maintained during an early stage of endotoxemia may decrease fluid flux across capillaries and may reduce pulmonary and multiple-organ edema.