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Transcapillary fluid balance in pre‐eclampsia
Author(s) -
ØIAN PÅL,
MALTAU JAN MARTIN,
NODDELAND HARALD,
FADNES HANS OLAV
Publication year - 1986
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1986.tb07899.x
Subject(s) - interstitial fluid , oncotic pressure , hydrostatic pressure , vascular permeability , eclampsia , medicine , interstitial space , tissue fluid , chemistry , extracellular fluid , anatomy , extracellular , biology , mechanics , pregnancy , albumin , biochemistry , physics , genetics
Summary. The fluid transport between the plasma and interstitial fluid compartment is governed by the Starling forces, i.e. the capillary pressure (P c ), interstitial fluid hydrostatic pressure (P i ) and colloid osmotic pressure in plasma (COP p ) and interstitial fluid (COP i ). Interstitial fluid was collected from subcutaneous tissue on the thorax and ankle by implanted wicks and Pi was measured using the ‘wick‐in‐needle’ technique. In pre‐eclampsia, COP p , is reduced due to hypoproteinaemia and this predisposes towards loss of fluid from the vascular compartment. An important oedema‐preventing mechanism is reduction of COP i , which serves as a homeostatic buffer against increased capillary filtra‐tion. This mechanism works in moderate, but not in severe preeclampsia. A higher COP i was found both at the thorax (8·3 vs 7·0 mmHg) and ankle (5·9 vs 3·9 mmHg) in the group with severe pre‐eclampsia compared with the group moderate pre‐eclampsia, in spite of a significant reduction in COP p (15·5 vs 19·9 mmHg). These findings suggest that an increased microvascular permeability of plasma proteins to subcutaneous tissue contributes to COP p reduction in severe pre‐eclampsia.