Studies of Hemoglobinemia and Hemoglobinuria Produced in Man by Intravenous Injection of Hemoglobin Solutions

The Effect of Hemoglobin on Renal Function in the Human

“…The mean per cent of filtrate unresorbed by the tubules decreased from a control value of 5.2 per cent to 2.5 per cent during the first postinjection period, and as was the case with hemolyzed blood, tubular reabsorption of filtrate during period 8 was no longer significantly elevated from control levels (Table III). (11,12,20). Although the agent effective in producing the alterations in renal function observed in the present study has not been clearly identified, it seems most likely that either hemoglobin per se or some product of its intravascular catabolism was responsible.…”

“…This latter viewpoint holds that the presence of heme pigments in the plasma and urine is merely an incidental finding (6). It has been supported by a number of reports on the intravenous administration of hemoglobin solutions to the human (7)(8)(9)(10)(11)(12) which generally agree that hemoglobin can be administered without untoward reaction, although no data on acute renal functional studies have been reported. Recently, however, Amberson and associates (13) have reported late and persistent decreases in renal clearances in a single hypertensive subject following the injection of hemoglobin.…”

Circulating Red Cell Volume Measured Simultaneously by the Radioactive Iron and Dye Methods 1

“…Values for normal plasma volume in man determined by several workers are in general agreement both as to absolute plasma volume and plasma volume per unit of body measurement (2, 5 to 7). The method has also proved reliable in the study of intravenous crystalloid (8) and colloid (9) therapy as well as in experimentally induced (10 to 12) and clinical shock (7, 12 to 14). A recent improvement in the method described by Noble (15), in which changes in dye concentration of blood samples are corrected for variations in water content as determined by serum protein measurements, should increase the applicability of the technique.…”

Acute Hemolytic Anemia From the Sulfonamides

“…The normalliver excretes in 24 hours an amount of bilirubin derivable from destruction of about 12% grams of hemoglobin (27) but is known to have considerable reserve capacity (28). The previous experimental injection of amounts up to 8 grams of hemoglobin produced scarcely measurable increases in blood bilirubin (13); injections of amounts up to 16 grams produced slight bilirubinemia (29). That the jaundice is due to the excess of bilirubin rather 10 Many cases of hemolytic anemia have gross hematemesis and melena (24).…”