Chemical, Clinical, and Immunological Studies on the Products of Human Plasma Fractionation. Vii. Concentrated Human Serum Albumin 123

161

In order to determine the relative dosage of plasma and of serum albumin in the treatment of shock and to determine their efficiencies in increasing blood volume and other characteristics, we have measured the osmotic pressure of human plasma and serum, of regenerated solutions from dried plasma up to four-fold physiological concentrations, of human serum albumin solutions up to 300 grams per liter in 0.15 molar sodium chloride, and of bovine serum albumin over large ranges of pH, albumin concentration, and salt concentration.3 We have not been able to detect a difference in the osmotic pressures of human and bovine albumin, so we have used the measurements on bovine albumin to extend the range of those on human albumin.The first function of plasma or serum albumin in shock is to increase the blood volume by holding water in the blood stream. Parts of the water may be injected with the protein, may be shifted from the extravascular fluids, or may be drawn from the intestine. This water must be held in spite of the excess pressure in the capillary bed.

mentioning

confidence: 68%

Chemical, Clinical, and Immunological Studies on the Products of Human Plasma Fractionation. Vi. The Osmotic Pressure of Plasma and of Serum Albumin 12

Scatchard¹,

Batchelder²,

Brown³

1944

161

“…' This study was carried out in order to provide more detailed information on the mechanism of the action of albumin in shock than was possible in the original clinical appraisal (2). use of the blue dye, T-1824, as described by Gregersen, Gibson, and Stead (7), and adapted to the Klett photoelectric colorimeter or the Beckman quartz spectrophotometer.…”

mentioning

confidence: 99%

Chemical, Clinical, and Immunological Studies on the Products of Human Plasma Fractionation. Ix. The Treatment of Shock With Concentrated Human Serum Albumin: A Preliminary Report 12

Warren

Stead²,

Merrill³

et al. 1944

We have had the opportunity to treat 6 patients in shock with concentrated human serum albumin, prepared from pooled normal human plasma by the method of Cohn and co-workers (1).3 Five of these patients had circulatory failure from hemorrhage and the sixth from extensive burns. These observations were made at the beginning of our experience with the technics utilized in the study of shock by Cournand and co-workers (3). At this time, routine determinations of the cardiac output before and after therapy were not being made. METHODSThe arterial pressure was recorded from the femoral artery by the method of Hamilton (4). The mean pressure was computed from planimetric measurement of these tracings. The right auricle was catheterized by a method only slightly modified from that reported by Cournand and Ranges (5). Mixed venous blood was obtained from the right auricle and arterial blood from the femoral artery. The oxygen content of these specimens was determined by the method of Van Slyke (6 ' This study was carried out in order to provide more detailed information on the mechanism of the action of albumin in shock than was possible in the original clinical appraisal (2). use of the blue dye, T-1824, as described by Gregersen, Gibson, and Stead (7), and adapted to the Klett photoelectric colorimeter or the Beckman quartz spectrophotometer. Plasma protein concentration was determined by the specific gravity method of Barbour and Hamilton (8). RESULTSCase 1. A 45-year-old Negro was admitted to Grady Hospital because of stab wounds of the right forearm, forehead, and right flank. He had bled profusely, but there was no evidence of penetration into the peritoneal cavity. He had been drin,king whiskey and the blood alcohol concentration was 180 mgm. per cent. The tongue was pale, the radial pulse was weak, and the extremities were cool. There was no sweating. The veins of the forearm were visible and appeared full. The venous blood from the antecubital vein was dark. The systolic brachial blood pressure by the auscultatory method was 80 mm. of Hg, the diastolic, 60 mm. The pulse rate was 96 beats per minute. The observations recorded in Table I were made and at the end of this time the patient's condition seemed unchanged. Two hundred cc. of a 25 per cent solution of albumin were given in 50 minutes. Following this, further studies were made. During the period of time from the beginning of the auricular catheterization to the completion of the second cardiac output, the patient received 200 cc. of normal saline by way of the catheter. The patient improved steadily while the albumin was administered and had no untoward reaction. His hands became warmer, the volume of the pulse increased, and he was less restless. His convalescence was uneventful.Case 2. A 20-year-old Negress was admitted to the Grady Hospital soon after being stabbed in the posterior aspect of the right chest. The patient was slightly restless; the extremities were cool and somewhat moist.By auscultation, the arterial pressure was 80/60. Physical examina...

“…The tration since the hematocrit values also decreased. concentration of protein in the plasma and in the In a third patient (P. F.) the plasma volume did ascitic fluid increased markedly, as noted in prenot change significantly; in the fourth case (A. vious studies (19)(20)(21)(22)(23) cr.r-r-w-v-v----ously observed (19)(20)(21)(22). Since the changes in the serum electrolytes and ascitic fluid electrolytes paralleled each other, only alteration 'in the serum electrolytes will be discussed.…”

Section: (B) Increased Water Intakementioning

confidence: 65%

Observations on the Alterations in Electrolytes and Fluid Balance in Patients With Cirrhosis of the Liver With and Without Ascites

Ricketts¹,

Eichelberger²,

Kirsner³

1951