THE SIGNIFICANCE OF ONCOMETRY FOR INFUSION THERAPY DURING PEDIATRIC HEART-SURGERY

Background. The colloid osmotic pressure (COP) is not routinely assess ed during pediatric heart surgery. Two cases of unrecognized hyperonco tic states associated with renal failure have been observed after pedi atric heart surgery. We studied the hypothesis that the COP cannot be estimated from the total plasma protein (TPP) or albumin level, Method s. The course of COP and its correlation to the TPP and albumin level were investigated in 25 children undergoing elective heart surgery, In fusion therapy was performed solely on the basis of clinical parameter s and TPP/albumin levels. COP values were determined in a blinded fash ion at the end of the study. Results. No correlation between TPP/album in and the COP could be determined preoperatively, On arrival at the I CU correlation was strong. A weak correlation was observed at 24 hours and 48 hours after surgery. However, the observed wide range of the c onfidential bands indicates that the COP cannot be estimated correctly , neither from the TPP, nor from the albumin level. Due to colloidal o versubstitution COP was significantly increased compared to preoperati ve level at 48 hrs following surgery. Conclusions, As estimation of CO P from TPP or albumin level is inaccurate, oncometry should be perform ed during pediatric heart surgery.