Studies on Cyanosis

Lundsgaard, Christen

doi:10.1084/jem.30.3.259

Cited by 39 publications

(6 citation statements)

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“…These figures and the result of the x-ray and clinical examinations make it certain that the left lung must have been compressed to such an extent that not only was the passage of air prevented, but also the blood flow. This furthermore is in accordance with the fact that the patient was not cyanotic (10).…”

Section: Experiments 5 Patient With a Large Exudate In The Left Pleura; An Almostsupporting

confidence: 89%

“…This shows that the circulation of the blood must have been very rapid and that the alveoli of the lungs immediately were supplied with oxygen-rich air. The experiment is in accordance with a similar one done by one of us in 1919 on the same subject (10). No cutaneous blood was drawn at that time.…”

Section: F~xperiment 8 Normal Resting Individual After Inspiration Osupporting

confidence: 63%

“…The figure (94.3 per cent) approximates very closely that usually given as the average figure for normal resting individuals. The oxygen content of the venous blood was the same as that usually found in normal resting individuals, but it differs from the values found in a series of experiments on the oxygen content of the venous blood after exercise in similar individuals (10). The analyses show that the largest possible discrepancy that can exist between the oxygen saturation of arterial and cutaneous blood is 5.7 per cent.…”

Section: Determination Of the Oxygen Content Of The Blood--vansupporting

confidence: 41%

“…On the other hand, it is not unlikely that the deoxidation in the capillaries was relatively small on account of increased blood flow. Half of the sum of the oxygen unsaturation of the cutaneous (arterial) and the venous blood is 8 to 9 volumes per cent, which is well above the threshold value at which cyanosis usually appears (10). That the cyanosis was found to be generalized is in accordance with its arterial (pulmonary) pathogenesis.…”

Section: F~xperiment 8 Normal Resting Individual After Inspiration Omentioning

confidence: 80%

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Investigations on the Oxygen Content of Cutaneous Blood (So Called Capillary Blood)

Lundsgaard

Möller

1922

Journal of Experimental Medicine

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1. A procedure is devised whereby cutaneous blood (so called capillary blood) from a finger-tip can be obtained for gas analyses without coming in contact with the air. 2. Determination was made of the oxygen content of the arterial, cutaneous, and venous blood respectively from a normal resting individual, the arterial and cutaneous blood showing the same oxygen content (97.5 and 96.6 per cent of the total oxygen-combining power of the blood). Venous blood drawn simultaneously was 75 per cent saturated. 3. Using the fact that there is a maximum value for the oxygen-combining power of the blood, we have shown, without doing arterial puncture, that under different conditions (normal and pathological individuals, resting and after exercise) the cutaneous blood and the arterial blood are almost identical as far as the oxygen content is concerned. 4. We think that we are justified in extending the identity, found between the oxygen content of the arterial and cutaneous blood, to other substances in the blood, for instance sugar, salt, uric acid, etc., and also to the reaction of the blood. 5. We are unable to say whether this identity between cutaneous and arterial blood is always true; for example, in a patient with increased venous pressure. 6. In all the experiments we have discarded the first drop of blood, which in some instances was darker than the rest, and always used at least 2 cc. of cutaneous blood. Whether the same results would be obtained with a very small amount of blood, for instance 0.2 to 0.4 cc., we do not know. 7. The experiments show that unless the perfusion of the skin has been extremely great during the experiment, samples of blood obtained from an incision in the skin (of the finger) cannot represent the true capillary blood. The neutral expression cutaneous blood seems therefore for the present preferable to the term capillary blood for samples of blood obtained by cutaneous incisions.

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Section: Experiments 5 Patient With a Large Exudate In The Left Pleura; An Almostsupporting

confidence: 89%

Section: F~xperiment 8 Normal Resting Individual After Inspiration Osupporting

confidence: 63%

Section: Determination Of the Oxygen Content Of The Blood--vansupporting

confidence: 41%

Section: F~xperiment 8 Normal Resting Individual After Inspiration Omentioning

confidence: 80%

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Investigations on the Oxygen Content of Cutaneous Blood (So Called Capillary Blood)

Lundsgaard

Möller

1922

Journal of Experimental Medicine

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“…In normal patients, measured as in this study, this ratio is usually well below 0.5. The hemoglobin concentration and the hematocrit give very little information with regard to 8 Three patients were studied after improvement of their condition had been observed clinically. Patient number 12 had little anoxia and very little increase in cell volume.…”

Section: Resultsmentioning

confidence: 99%

A study of the volume of the blood in congestive heart failure. Relation to other measurements in fifteen patients

1944

American Heart Journal

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While the volume of the blood in health is quite constant and closely related to the size, age, and sex of the individual, it has long been recognized that in congestive heart failure, this relationship is disturbed. Therefore, investigations of the volume of the blood in this clinical condition should throw light on the mechanism of normal control of the volume of the blood as well as on the nature of the physiological disturbances involved in heart failure itself. Studies of this nature, summarized by Gibson and Evans (1), indicate that there is an increase in the volume of the blood in this condition. While this generality is well supported, there is a striking variability in individual cases. It appeared likely that this variability might be accounted for if quantitative measurement of factors which might influence blood volume were made at the time of the determination of the blood volume. Since the association between anoxemia and compensatory polycythemia is well established, measurements of arterial and venous oxygen were made and it proved possible to show a rough quantitative relationship between anoxemia and cellular increase. On the other hand, while the statement has been made (1, 2) that there is a positive relationship between the venous pressure and the change in blood volume in congestive heart failure, it was not possible to find such a relationship within this group of severely congested cardiac patients.Although a number of the lines of investigation pursued did not lead to the establishment of any simple correlation with plasma or cell volume changes, these data presented are of interest, not only in themselves, but also because certain interesting relations obtain between them. The results of these studies conducted on cardiac patients are therefore presented in full.1 Louisiana State University School of Medicine, New Orleans, La. MATERIALFifteen patients were selected who had clinical evidence of severe congestive heart failure (class IV). All were dyspneic or orthopneic, all but one had pitting edema, all but one had hepatomegaly, most had chronic passive congestion of the lungs, a few had hydrothorax, several had ascites. The clinical findings in these patients are summarized in Table I. Every effort was made to select uncomplicated cases, who were untreated, or who were in a steady state despite digitalis. Etiology of the heart disease in these cases included rheumatic heart disease, arteriosclerosis, hypertension, thyrotoxicosis, syphilis, and heart disease secondary to pulmonary disease. The duration of failure ranged from a few weeks to several years. Patient number seven had evidence of a moderate degree of renal insufficiency and he also had hemoptysis. None of the others had evidence of chronic blood loss. Five patients were female and ten were male. The average age was 542 years, with one subject in the third decade, five in the fourth decade, four in the fifth, and five in the sixth decades. METHODSThe patient was brought to the laboratory in bed in the post-absorptive state. T...

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Studies in Oxygen Therapy

Barach¹,

Woodwell²

1921

Arch Intern Med (Chic)

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In the previous paper, a report was made of the effect of oxygen on two normal individuals and seven cases of cardiac insufficiency. This paper represents a continuance of the studies in oxygen therapy in ten cases of lobar pneumonia and two cases of bronchopneumonia. The theoretical indications for giving oxygen, the methods employed, and the recent pertinent literature have been outlined in the beginning of the first paper. The plan of investigation has been maintained, namely, the correlation of the clinical condition of the patient with the oxygen saturation of the arterial and venous blood before and after treatment. REPORT OF CASES The individual cases follow : Case 101 (Table 3).\p=m-\M.W., white, male, driver, 36 years. Diagnosis.\p=m-\Lobarpneumonia; chronic pulmonary tuberculosis; edema of the lungs. History.\p=m-\Mother and sister died of tuberculosis. Patient has suffered from a chronic productive cough for five years. Three days before entry, tiredness, headache, and sharp pain in left chest began. Two days later, cough increased in intensity, sputum resembled prune juice, and weakness became marked. Physical Examination.\p=m-\Jan.29, 1921 (fourth day of disease) : Temperature, 103.0 F.; pulse, 138; respiration, 32. Very poor nutrition. Moderate dyspnea. Marked cyanosis of nail beds. Consonating r\l=a^\lesover entire left chest. Dulness and diminished breath sounds at left base. Dulness and bronchovesicular breathing below right clavicle. Heart not enlarged. Sounds regular, rapid, good quality, without murmurs. Artery wall palpable. Blood pressure, 115/80. Urine, negative. Blood Wassermann, negative. White blood cells, 37,400; polymorphonuclears, 90 per cent. Blood cultures (two), sterile. Sputum, pneumococcus subtype II. Sputum for tubercle bacilli positive. Course and Treatment.-Routine pneumonia treatment (force fluids; soft solids; evening sedatives, usually morphin). Digitalis leaves, 1 grain, three times a day from Feb. 1 to IS, 1921. Jan. 31, 1921 (sixth day of disease): Temperature, 102.3 F.; pulse, 130; respiration, 30. Dyspnea and cyanosis as on admission. Patient mentally alert From the Medical Service of the Massachusetts General Hospital. This paper is No 16 of a series of studies of the physiology and pathology of the blood from the Harvard Medical School and allied hospitals. The expense of this work was in part defrayed by a grant from the Proctor Fund of Harvard University for the study of Chronic Diseases. 1. The cases in the three papers are numbered serially.

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Studies on Cyanosis

Cited by 39 publications

References 6 publications

Investigations on the Oxygen Content of Cutaneous Blood (So Called Capillary Blood)

Investigations on the Oxygen Content of Cutaneous Blood (So Called Capillary Blood)

A study of the volume of the blood in congestive heart failure. Relation to other measurements in fifteen patients

Studies in Oxygen Therapy

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