Further Observations on the Hemodynamic Effect of Plasma Volume Expansion by Dextran1

Abstract

An earlier study (1) indicated that the administration of 500 ml. of 6 per cent dextran to five patients produced hemodilution and increased the cardiac output. There was insufficient evidence in this study to correlate the increase in cardiac output with any phase of the hemodynamic change resulting from plasma volume expansion. In order to extend the previous observations, right au

Pulmonary vascular distensibility and lung compliance as modified by dextran infusion and subsequent atropine injection in normal subjects.

“…Probably, the variations of the total effective blood volume (44) and of the extracellular volume (43) may also influence the cardiac output. As to the effect of dextran infusion, previous findings show a variable increase of cardiac output probably depending on the rate of infusion and the amount given (35)(36)(37); our results are in general agreement with these reports. The increase of cardiac output resulted from a rise of both stroke volume and heart rate; this is also in agreement with previous observations (37).…”

“…The observed variations of the hematocrit value and of TBV and their duration after dextran infusion are in agreement with preceding reports (35)(36)(37)(38). Some conflict exists in the literature on the effect of induced hypervolemia on cardiac output.…”

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

“…Blood volume was increased by infusing through the catheter in the pulmonary artery a balanced multielectrolyte solution containing 3.5%o polyvinylpyrrolidone. 4 The solution is isotonic and isoviscous in relation to blood plasma (19) and was warmed to body temperature before injection. Infusion was accomplished by a motor-driven syringe at a constant rate of 38 ml per minute.…”

“…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).…”

“…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).…”