Abstract
Colloid osmotic pressure in plasma (IIp) and in subcutaneous interstitial fluid (IIi) (wick technique), plasma volume (PV) and interstitial fluid volume (IFV) were measured in 12 patients with hepatic cirrhosis and fluid retention. The value of IIp (mean±SD) was 21.4±4.2 mmHg (28.6±3.4 mmHg in normal subjects (p<0.01)), mean IIi was 8.6±2.2 mmHg (15.8±2.7 mmHg in normal subjects (p<0.01)) and mean transcapillary colloid osmotic gradient (IIp-IIi) was 12.7±3.8 mmHg compared to 12.8±2.7 mmHg in normal subjects (p<0.1). Mean PV was increased by 21% compared to normal values (p<0.01) and IFV increased by 43% (p<0.01). The study demonstrates that reduction in IIp in hepatic cirrhosis is accompanied by a decrease of IIi in subcutaneous tissue resulting in unchanged transcapillary colloid osmotic gradient. The reduction in IIi can partly be explained by simple dilution and partly by a decrease in interstitial protein mass. The wash-down of interstitial proteins in non-splanchnic tissues reduces the tendency to oedema and hypovolaemia.