Blood Replacement

Abstract

All rights reserved. No part of this book may be translated or reproduced in any form withoutwritten permission from Springer-Verlag. © by Springer-Verlag Berlin Heidelberg 1969. Library of Congress Catalog Card Number 69-16845Softcover reprint of the hardcover 1st edition 1969The use of general descriptive names, trade marks, etc. in this publication, even if the former are not especially identified, is not be taken as a sign that such names, as understood by the Trade Marks and Merchandise Act, may accordingly be used freely by anyone. Title-No. 1551 Dedicated to my wife LisaEs wurde fertig in Deiner Hut. Bleib Du mir auf dieser Erden, so 5011 alles fertig werden. THOMAS MANN ForewordThe manifold problems of shock are still of great importance, diagnostic and therapeutic experience of the "severely ill" being supplied with new information almost every month. In the 5 periodicals which have found their way to my desk during the past few days there are no less than 10 interesting articles on questions concerning shock research [see Bibliography 41 b, 53 a, 60 a, 192 a, 242 a, 350 b, 810 a, 941 a, 1069 a, 1082 a]. The most urgent point still is to maintain as complete as possible the objective catalog of the various shock manifestations found in man and in animals -yet at the same time to view interpretations of these phenomena in their relative and temporal "truth".Problems of shock research are not only interesting for their scientific value but also for their clinical implication. In particular, almost every practicing physician is facing problems of blood replacement very frequently. The effective or circulating blood volume remains an important theoretical and therapeutic problem in the shock field. For years, U. F. GRUBER has pursued this question clinically and experimentally. This volume deals with the world literature in an exceptionally thorough manner. This book is made more than a compilation by including a long list of original work done with F. D. MOORE in Boston, in the Surgical Department in Chur, with L. E. GELIN and S. E. BERGENTZ in Goteborg and in the Laboratory for Experimental Surgery in Davos; judgements are made on the basis of original studies, and essential points are separated from unimportant ones. This volume will be welcomed by the medical profession because it carefully treats vital questions concerning this complicated, much-discussed, and in part contested field, considering that today, along with various forms of blood and several plasma preparations, there are more than 40 different plasma replacement substances available with various physico-chemical, biological and pharmacological properties. Older preparations have been abandoned, others modified, and new ones appear.A comparative evaluation of the chemical characteristics, the range of indication and the therapeutic effectiveness of these solutions suggests itself particularly at this time because in recent years the use of large amounts of balanced electrolyte solutions tended to reverse the principles of blood replaceme...

A Comparison of the Effects of Salbutamol, Etilefrine and Dextran During Hypotension and Low Cardiac Output States in Rabbit

“…Other previous findings suggest that the pattern of changes in resting cardiovascular function induced by either salbutamol in cat (Bowman & Rodgel-1972;Lockwood & Sinkasaem 1976) and in dog (Daly, Farmer & Levy 1971;Nayler & McInnes 1972;Kelly & Shanks 1975) or etilefrine in cat (Mellander 1966), dog (Tarnow et a1 1973) and man (Coleman el al 1975) or dextran in many species (Witham, Flemming & Bloom 1951;Farrow 1967;Gruber 1969;Shoemaker & Monson 1973) are in agreement with the pattern presently presented. One new dimension, the increase in RHFP produced by salbutamol and etilefrine, is consistent with the increase in cardiac output produced by the two drugs.…”

“…The discrepancy is probably due to the differences in the species and doses used and in particular the state of the cardiovascular function immediately before the treatment. Dextran has also been used to augment cardiac contractility during myocardial impairment (Thal 1971), in hypovolaemia to improve cardiovascular function (Gruber 1969) and in the treatment of trauma and shock states (Shoemaker & Monson 1973). With the exception of a preliminary report (Adigun 1978), the effects of dextran 70 on the responses to LBNP in the rabbit have not been previously described.…”

“…These actions may account for the beneficial effects of the drug in human cadiac diseases Stephen, Banim & Spurrel 1980) and during circulatory shock in the dog where the improvement in cardiac output and total peripheral conductance tends to suppress the fall in blood pressure and the adverse blood chemistry changes (Anigbogu & Adigun 1983a, b). Etilefrine, a sympathomimetic drug with a-and 0-adrenoceptor mediated actions which may improve cardiac output, total peripheral conductance (especially at low dose) and blood pressure in man and animal (Tarnow et a/ 1973;Limbourg, Just & Lang 1974;Coleman, Leary & Asmal 1975); and dextran, a volume expander (Gruber 1969;Shoemaker & Monson 1973) may also provide the required cardiovascular support.…”

Effects of Hypertonic Saline (7.5%)/Dextran 70 on Human Red Cell Typing, Lysis, and Metabolism in vitro1

“…the quality of the stored red cells [6]. Many of the adverse effects are associated with dextran with an average molecular weight >150,000 [8,91. However, in studies where patients received dextran 70 or dextran 40 solutions, no adverse effects on blood serological tests were noted [5,9].…”

“…An additional problem has been the in vitro observation of increasing lysis when dog red cells were exposed to doses of hypertonic saline solutions >7.5% [8]. While it is well known that dog red cells are more fragile than human, and readily lyse under slight stress, stored human blood is also well known to increase its fragility during banked storage.…”