The Circulating Blood Volume in Diabetic Acidosis

Chang, Hsiao-Chien; Harrop, George A.; Schaub, Bianca

doi:10.1172/jci100167

Cited by 18 publications

(6 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Two of the patients showed an apparently significant increase in plasma volume during dehydration (table 1), four of them no significant change, and five a distinct diminution. The work of previous investigators on the dehydration of infants and children (5) and on that of adults in diabetic coma (14) had led us to anticipate a reduction of plasma volume wherever, as in our series, signs of dehydration of the subcutaneous tissues were present. In the light of our own studies, however, we believe that this view must be modified.…”

Section: Methodssupporting

confidence: 53%

Blood Volume and Plasma Electrolyte Changes in the Dehydration of Infants

McIntosh

Kajdi²,

Meeker³

1930

J. Clin. Invest.

View full text Add to dashboard Cite

In a general review of the subject of anhydremia published in 1923, Marriott (1) brought out several of the phenomena which had been shown to accompany severe clinical dehydration: an increase in the proportion of the total solids and in the dried weight of a unit volume of blood, an increase in its specific gravity, in red cell count and hemoglobin, and in the concentration of the serum proteins. He showed also, however, that when deprivation of fluid, either from lack of intake, from vomiting, or from diarrhea, persisted over a long period of time, a lowering of total solids, red count, and hemoglobin ensued, which was attributed to breakdown of body protein with the liberation of bound water. All of these phenomena might occur at a time when the plasma volume was subnormal, and consequently an investigation of the concentration of these substances in a unit volume of blood was shown to be of limited value in the study of the water economy as a whole in dehydration. Although these considerations emphasized the fatuity of placing reliance on the indirect evidence afforded by changes in the concentration of blood constituents and the necessity for direct investigation of blood and plasma volume changes in dehydration, such direct determinations have been singularly infrequent. Marriott mentioned some in a general way, but did not fully report his data.A number of studies made since 1923-for example, those of Hartmann (2) and of Hamilton, Kajdi and Meeker (3)-on the serum or plasma concentration of electrolytes in dehydration accompanying the infections and digestive disorders of infants have shown that a lowering of the total electrolyte concentration is, in fact, rather more com-333 BLOOD VOLUME AND ELECTROLYTES mon than an increase; and even when dehydration was brought about experimentally by reduction of the water intake, Schiff, Bayer, and Fukuyama (4) were unable to change the concentration of serum total fixed base beyond the limit of error of the method used. If, then, a lowering of serum electrolyte concentration of this kind, or even if no change in concentration occurs, one must abandon the concept that loss of water alone from the blood is the primary event in the development of dehydration, since this would only act to bring about a higher concentration of electrolytes. This actual lowering of serum electrolyte concentration in dehydration appeared to Hartmann (2) of sufficient importance to cause him to postulate that loss of electrolyte from the circulation might occur to an extent that required the body to retain nonprotein nitrogen constituents for their osmotic action so that the normal osmotic pressure of the plasma might be maintained. If water alone had been lost to excess, no such difficulty would have existed, for the osmotic pressure of the plasma would by that measure be increased. The lowering of serum electrolyte concentration could theoretically be brought about by dilution of the blood, though in view of the loss of body weight and the obvious loss of water from the body as a whole, ...

show abstract

Section: Methodssupporting

confidence: 53%

Blood Volume and Plasma Electrolyte Changes in the Dehydration of Infants

McIntosh

Kajdi²,

Meeker³

1930

J. Clin. Invest.

View full text Add to dashboard Cite

show abstract

“…The glycosuria plus the loss of sodium from the body lead to the well-recognized but inadequately verified contraction in extracellular fluid space of which the blood volume is an im-portant component (31,32). This can only result in a decrease in cardiac output compensated by a restriction in peripheral blood flow (25) and quite probably a marked decrease in renal blood flow.…”

Section: Discussionmentioning

confidence: 99%

The Blood Flow and Oxygen Consumption of the Human Brain in Diabetic Acidosis and Coma 1

Kety¹,

Polis²,

Nadler³

et al. 1948

J. Clin. Invest.

230

View full text Add to dashboard Cite

“…Glycosuria and polyuria entail a most devastating series of events that cause untold damage-dehydration, desiccation of the tissues, hemoconcentration, undernutrition through loss of sugar in the beginning and subsequently through increased pro¬ tein destruction and hypoproteinemia, acidosis, loss of electrolytes of the intracellular and extracellular fluids, diminished oxygen capacity of the blood, and decreased blood supply to the skin, heart and muscles. The idea that these changes, detected by painstaking laboratory determinations, are due entirely to polyuria and glyco¬ suria and are not brought about by uncomplicated hyper¬ glycemia alone, is generally acknowledged (Chang, Harrop and Schaub, 12 Lande, 13 Atchley and his asso¬ ciates,14 Peters, Kydd and Eisenman,1 and Himwich and his associates 15 ). When these effects of sugar and water loss have become manifest, all these authors agree that the blood sugar may be reduced to normal and yet the condition may be far from controlled, thus indi¬ cating that blood sugar is not the pivotal point in the treatment of diabetes.…”

Section: Normal Blood Sugar Levelmentioning

confidence: 99%

Hyperglycemia

Mosenthal¹

1935

JAMA

View full text Add to dashboard Cite

The Circulating Blood Volume in Diabetic Acidosis

Cited by 18 publications

References 2 publications

Blood Volume and Plasma Electrolyte Changes in the Dehydration of Infants

Blood Volume and Plasma Electrolyte Changes in the Dehydration of Infants

The Blood Flow and Oxygen Consumption of the Human Brain in Diabetic Acidosis and Coma 1

Hyperglycemia

Contact Info

Product

Resources

About