Development of new colloid osmotic pressure measurement method using ultrafiltration membrane during cardiopulmonary bypas

Takeshi Matsumoto, K. Yoshida, Tomotaka Shinohara, E. Miyoshi, T. Ueno
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Abstract

Background: Clinical practice of measuring colloid osmotic pressure (COP) was abandoned after correcting hypoosmolarity did not improve overall patient outcomes. However, the use of albumin and colloidal solutions has contributed to maintaining intraoperative and postoperative fluid balance at lower levels. Reduced perioperative fluid balance is consistently reported to have positive effects on clinical outcomes. Priming solutions for cardiopulmonary bypass typically include colloids; however, the optimal type of priming solution has not yet been determined. Stricter COP management may further improve postoperative courses. To achieve this, the widespread adoption of a measurement method suitable for COP monitoring during cardiopulmonary bypass is required. Methods: A test circuit was made which measured COP using an ultrafiltration membrane method based on the changes in hydrostatic pressure that occurs across a semipermeable membrane. We then compared the measurements obtained using this method with colloidal osmometer measurements. Results: COP measurements were obtained for a total of 100 tests (10 times each for 10 test solutions). The evaluation parameters included simultaneous reproducibility, correlation with colloid osmometer, and measurement time. The results demonstrated high accuracy of the ultrafiltration membrane method, simultaneous reproducibility within 3%, a high positive correlation with the colloid osmometer (correlation coefficient: R2 = 0.99; p < 0.01), and
体外循环中超滤膜胶体渗透压测量新方法的建立
背景:在纠正低渗透压后,放弃了测量胶体渗透压(COP)的临床实践,并没有改善患者的总体预后。然而,白蛋白和胶体溶液的使用有助于维持术中和术后较低水平的液体平衡。减少围手术期体液平衡一直被报道对临床结果有积极影响。体外循环的启动解决方案通常包括胶体;然而,最优的引液类型尚未确定。更严格的COP管理可进一步改善术后病程。为了实现这一目标,需要广泛采用一种适用于体外循环期间COP监测的测量方法。方法:采用超滤膜法,根据半透膜上静水压力的变化,制作了测试回路。然后,我们将用这种方法获得的测量结果与胶体渗透计测量结果进行了比较。结果:共获得了100次测试的COP测量值(10个测试溶液各10次)。评价参数包括同时重现性、与胶体渗透计的相关性和测量时间。结果表明,超滤膜法准确度高,同时重现性在3%以内,与胶体渗透计具有高度正相关(相关系数:R2 = 0.99;P < 0.01)
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