Effect of the intravenous administration of dextran on cardiac output and other circulatory dynamics

Behavior of Normal Pulmonary Circulation during Changes of Total Blood Volume in Man*

“…It has been demonstrated by many authors, both in patients with heart disease and in normal subjects, that the pulmonary arterial and venous pressures can be raised or lowered by increasing or decreasing the total blood volume (1)(2)(3)(4)(5)(6). These pressure alterations are generally thought to occur in association with changes of the pulmonary blood volume, which is believed to increase or decrease simultaneously with a rise or fall in total circulating volume (1-3, 7, 8).…”

“…These pressure alterations are generally thought to occur in association with changes of the pulmonary blood volume, which is believed to increase or decrease simultaneously with a rise or fall in total circulating volume (1-3, 7, 8). However, in the majority of reports published on this subject, the pulmonary blood volume was either not measured (1,5,6) or estimated from "central" blood volume determinations (2,3,7), which are known to encompass many drawbacks and pitfalls (9,10). More recently, Oakley and associates (11) studied four patients with rheumatic heart disease during the intravenous administration of dextran or saline solutions and found an increase of the pulmonary blood volume measured by the method of Milnor, Jose, and McGaff (12).…”

“…In these experiments the pulmonary arterial and left atrial pressures were raised or lowered by the rapid infusion or withdrawal of relatively large volumes of blood (13). No human counterpart of such findings is available in the literature, since data on the pulmonary vascular resistance obtained during similar studies carried out in intact man are scarce and inconsistent (2)(3)(4)11).…”

Studies on Starling's Law of the Heart. I. The Circulatory Response to Acute Hypervolemia and Its Modification by Ganglionic Blockade

“…A variety of fluids has been utilized in such studies in man, including saline (1-4), dextran (4-6), glucose solutions (4), and human serum albumin (2,7). In general, the results have been conflicting, with a few investigators noting an increase both in filling pressure and cardiac output (1,5), while in the majority of studies no consistent relationship between these parameters was noted (2-4, 6, 7). Indeed, in most human subjects the augmentation of the total blood volume has failed to be associated with a rise in cardiac output, even in the face of a decline in hematocrit (2-4, 6, 7).…”

Circulatory Effects of Chronic Hypervolemia in Polycythemia Vera*

“…It is possible that the increased cardiac output observed in five of the ten subjects was in part dependent upon increased venous return, similar to the transient effects described with acute hypervolemia in dogs (15). From other studies there is evidence that acute hypervolemia achieved by the infusion of dextran and other blood volume expanders increases output (2,4,6,16). These techniques also produce a decrease in hematocrit as a complicating feature.…”