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A disadvantage is represented by increased edema formation due to inadequate oncotic pressure of artificial perfusion solutions (Domingo-Pech et al., 1991; Zeitlin and Eshraghi, 2002); however, weight gain of organs has also been reported in experiments using diluted whole blood as perfusate (Friebe et al., 2013a).
The plasma oncotic pressure was measured as mmHg with an Osmomat 050 Colloid Osmometer Viscometer (Gonotec GmbH, Germany).
These mechanisms probably include increasing plasma protein oncotic pressure, differences in peripheral vasoconstriction in active muscles and inactive tissues, and elevated lymph flow.
Immunologic changes, increased ventilatory demand, and decreased functional residual capacity and oncotic pressure all are postulated to predispose pregnant and postpartum women to severe respiratory complications from influenza virus infection (5,6).
Factors that could affect the PRR include: low albumin level (to sustain plasma oncotic pressure), congestive heart failure, reduced plasma osmolality, hypoxaemia, ischaemia, septicaemia, fever, autonomic dysfunction, and ingestion of anti-hypertensive medications (Amato, et al., 2008, Raimann, et al, 2008).
Decreased plasma oncotic pressure, as occurs in hypoproteinaemia during malnutrition, precipitates oedema (8).
Table One: Liver functions and consequences of failure Liver function Consequences of failure Metabolism, synthesis and storage * malnourishment of carbohydrates, fats and * low serum albumin leading to: proteins (including albumin) low plasma oncotic pressure, ascites, and cerebral edema.
Increased permeability of the pleural membrane, increased pulmonary capillary pressure, decreased negative intrapleural pressure, decreased oncotic pressure, and obstructed lymphatic flow are some of the mechanisms leading to an increase in pleural fluid.
Albumin is a major contributor to oncotic pressure of plasma.
The role of low intravascular oncotic pressure as a cause of outward fluid movement has been overstated, as experimental models and most patients with nephrotic syndrome do not show a decreased transcapillary osmotic gradient.
A further explanation for the increase of % TBW could be an increase in circulating proteins inducing an increase in plasma oncotic pressure. An increase of plasma protein concentration--especially albumin--might explain an increase in PV.
Crystalloids will result in a reduced plasma oncotic pressure and an accumulation of fluid in the tissues.