DIE ROLLE DES PLASMACOLLOIDOSMOTISCHEN DRUCKES IM HAMORRHAGISCHEN SCHOCK UND BEI DER PULMONALEN UND SYSTEMISCHEN ODEMBILDUNG

The effects of reduced colloid osmotic pressure (COP), as seen after resuscitation from hemorrhagic shock, on fluid filtration and water content in the pulmonary and systemic microcirculation were examined during acute plasmapheresis in seven nonanesthetized sheep prepared with chronic lung and systemic lymph fistulas. A 50.5% reduction of COP resulted in significant increases in lymph flow (pulmonary 311% of baseline, systemic 196%) and a significant increase in soft tissue water content, but there was no change in extravascular pulmonary water. The lung seems to be prevented by lymphatic safety factors against development of hypoproteinemic edema in moderate COP reductions. Pulmonary edema after hemorrhagic shock cannot be explained by reduced COP.