The Effects of Dextran in Normovolemic and Oligemic Subjects 1

Hammarsten, James F.; Heller, Ben I.; Ebert, Richard V.

doi:10.1172/jci102744

Cited by 27 publications

(12 citation statements)

References 6 publications

(3 reference statements)

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“…The exact cause of the water diuresis initiated by dextran infusion has not been determined. 4. Observations during dextran infusion in four children suggested that the calculated permeability of the glomerular membranes to albumin (a) is relatively increased in the nephrotic syndrome as previously demonstrated by others, (b) may increase further during dextran infusion, and (c) appears to be independent of that for water.…”

supporting

confidence: 56%

Effects of Infusion of Hyperoncotic Dextran in Children with the Nephrotic Syndrome1

James¹,

Gordillo²,

Metcoff³

1954

J. Clin. Invest.

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Dextran is a bacterial polysaccharide which is being increasingly used as a plasma substitute (1-4). Dextran molecules frequently have a molecular weight of several million, and consist of long branched chains of glucose units. For clinical use these large molecules are broken down artificially to an average molecular weight of 70,000. In the body, the larger molecular aggregates are further broken down and excreted as smaller fractions having (approximate) molecular weights less than 20,000, or are slowly metabolized.Dextran has been reported to induce diuresis regularly in patients with the nephrotic syndrome (5, 6). In addition to determining the clinical value of dextran, the intravenous infusion of hyperoncotic (12 per cent) dextran in water was used as an approach to the study of the following questions: 1) Effect of increased plasma volume on glomerular filtration rate;2) The relation of plasma volume, serum albumin concentration, and glomerular filtration rate to the glomerular permeability to albumin;3) The effect of increased post-glomerular colloid osmotic pressure on tubular reabsorption of water and solutes;4) The nature of the dextran-induced diuresis. METHODNephrotic children who showed no clinical evidence of renal failure were selected (i.e., no concomitant acidosis, azotemia and anemia). The children were recumbent during the study period. Infusions were administered

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supporting

confidence: 56%

Effects of Infusion of Hyperoncotic Dextran in Children with the Nephrotic Syndrome1

James¹,

Gordillo²,

Metcoff³

1954

J. Clin. Invest.

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“…The plasma protein pool has been reported to decrease (2,3,22), to remain essentially unchanged (23), or to increase (24), and while there is disagreement as to whether albumin or globulin is more affected by dextran infusion, the plasma concentrations of both have been noted to decrease (2-6, 21-25).…”

Section: Discussionmentioning

confidence: 99%

Studies on Albumin Synthesis: The Effects of Dextran and Cortisone on Albumin Metabolism in Rabbits Studied With Albumin-I131*

Rothschild¹,

Oratz²,

Wimer³

et al. 1961

J. Clin. Invest.

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Following plasmapheresis, the depressed serum albumin concentration rapidly returns to normal (1) indicating alterations in albumin synthesis or degradation. Both dextran administration (2-6) and elevation of serum globulin levels produced by means of hyperimmunization (7,8) are associated with hypoalbuminemia; a colloid osmotic regulatory mechanism has been suggested as responsible for the reciprocal changes in serum proteins observed after hyperimmunization (7, 9). If such a mechanism does exert control over the concentration of serum albumin, alterations of albumin metabolism either in the rate of synthesis or in the rate of degradation might be expected when osmotically active molecules other than albumin are added to the circulation. The present study represents an attempt to define, more specifically than heretofore reported, the changes in albumin metabolism resulting from such a procedure. Dextran was administered to rabbits to depress albumin concentration. After the development of hypoalbuminemia, the rates of albumin synthesis and degradation were studied and compared with control values. Cortisone acetate was then given to increase the rate of albumin degradation (10), and the rates of albumin synthesis were remeasured. METHODSFemale rabbits were used in all studies. Animals were kept in metabolism cages and fed a standard rabbit diet.

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“…The opposite effect occurs with administration of diluted solutions: the excess water leaves the circulatory system quickly, but approx. 20-25 ml water per g dextran will remain in circulation [378, 638,639,808,809,838].…”

Section: M~mentioning

confidence: 99%

“…The duration of the volume effect of a dextran solution depends on the initial volume here as well. In hypovolemic individuals and those who have reduced colloid-osmotic pressure, the effect lasts longer than in healthy normovolemic individuals ( [639,754]; see also [1313,1488]). …”

Section: U) the Volume Effect Of Dextranmentioning

confidence: 99%

Blood Replacement

Gruber¹

1969

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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...

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The Effects of Dextran in Normovolemic and Oligemic Subjects 1

Cited by 27 publications

References 6 publications

Effects of Infusion of Hyperoncotic Dextran in Children with the Nephrotic Syndrome1

Effects of Infusion of Hyperoncotic Dextran in Children with the Nephrotic Syndrome1

Studies on Albumin Synthesis: The Effects of Dextran and Cortisone on Albumin Metabolism in Rabbits Studied With Albumin-I131*

Blood Replacement

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