Changes In COP Of Elderly Patients In Gastrointestinal Surgery Perioperative Period

Objectives:The changes in colloid osmotic pressure of plasma (COP) is discussed by monitoring the COPs of elderly patients at six time points in gastrointestinal surgery perioperative period, to provide a certain experimental basis to the infusion plan in perioperative period.Methods:1.92elderly patients were selected for receiving gastrointestinal surgery (age ranging from65to80, with weight among50and70kg), ASA Ⅱ class; bowel preparation was given before operation. All patients were given general anesthesia, Multiple Electrolytes Injection of8-10ml/kg·h was injected before rapid sequence induction, and mechanical ventilation was offered after intubation. The colloids and crystalloids were used during operation in the proportion1:1, with fluid replacement of6～10ml/kg·h, where the hydroxyethyl starch130/0.4in sodium chloride injection were used as colloidal fluid.2. Sampling was made on an empty stomach at the six time points selected (T1-T6), and a membrane colloid osmometer was used to measure the COP value; T1was the morning after8hours of fasting and water-deprivation at time of admission; T2was the time when establishing venous access in operation room; T3was time when the tracheal tube was removed after operation is completed; T4was the next morning thereafter; T5was the next morning the patients were appeared with postoperative complication, yet the morning of5th day for patients with no complications; T6was the morning of the day before discharge. SPSS17.0was employed to analyze the relevant experimental data. t-test was used for measurement data and chi-square test was for enumeration data, showing statistical significant in difference, P<0.05.Results:1. COP value of patients before anesthesia increased comparing with that at time of admission, and the difference was statistically significant (P<0.01);2. COP value of patients at time of extubation decreased comparing with that before anesthesia, showing the statistical significance (P<0.05);3. COP values of patients with complications after operation at T3, T4and T5were lower than that of patients with non-complications, showing the statistical significance (P<0.01);4. COP values of patients with operation duration greater than3hours were lower than that within the3hours, showing the statistical significance (P<0.01);Conclusion:There was a decline in postoperative COP of elderly patients receiving gastrointestinal surgery comparing with the COP before operation, while the patients with complications presented more significant COP reduction. The use of membrane colloid osmometer in measuring COP is fast and accurate, suitable for the clinical application.