Changes in colloid osmotic pressures could cause fluid accumulation after Fontan surgery

Marianne Müller Indrebø‘s main research aim was to evaluate intravascular and interstitial colloid osmotic pressures in children with congenital heart defects.


  1. Children with congenital heart defects have lower colloid osmotic pressures i plasma than healthy children.
  2. Surgical closure of atrial septal defects is associated with a higher drop in colloid osmotic pressure than non-surgical closure.
  3. Fluid accumulation after Fontan surgery associate with changes in colloid osmotic pressures.


Thesis: Fluid accumulation and transcapillary fluid balance in children with congenital heart defect. Evaluation of colloid osmotic pressures assessed by the wick method.
Candidate: Marianne Müller Indrebø
Time: June 23, 2020 at 11:15
Place: Online-based solution, due to the covid-19 situation
Link to university website


(1) Mean colloid osmotic pressure in young children’s plasma is 25-26 mmHg in both girls and boys. It is higher in children aged 8-10 than in younger children, and comparable to colloid osmotic pressures in adults.

99 healthy children aged between 2 and 10 years were included in the study. Colloid osmotic pressures were measured in plasma and interstitial fluid harvested from nylon wicks.

(2) Colloid osmotic pressure in plasma is only 20-21 mmHg in children with atrial septal defect. Both plasma and interstitial osmotic pressures dropped more following closure surgery than after a non-surgical procedure, leading to increased colloid osmotic gradient in the surgical group. This could possibly explain the tendency for more fluid accumulation with pericardial effusion following surgical closure of atrial septal defects.

(3) 39 children with univentrical hearts had a mean colloid osmotic pressure in plasma of 20-21 mmHg before undergoing bidirectional or total cavopulmonary connection. The colloid osmotic pressure in plasma was slightly reduced during the Fontan surgical procedures and normalized after surgery. Interstitial colloid osmotic pressure decreased significantly after surgery and was associated with pleural effusion.


(1) Guthe, H. J. T., Indrebø, M., Nedrebø, T., Norgård, G., Wiig, H., & Berg, A. (2015). Interstitial fluid colloid osmotic pressure in healthy childrenPloS one10(4), e0122779.

(2) Indrebø, M., Berg, A., Holmstrøm, H., Seem, E., Guthe, H. J., Wiig, H., & Norgård, G. (2018). Fluid accumulation after closure of atrial septal defects: the role of colloid osmotic pressureInteractive cardiovascular and thoracic surgery26(2), 307-312

(3) Indrebø, M., Berg, A., Holmstrøm, H., Seem, E., Guthe, H. J. T., Wiig, H., & Norgård, G. (2019). Fluid accumulation in the staged Fontan procedure: the impact of colloid osmotic pressuresInteractive cardiovascular and thoracic surgery28(4), 510-517

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