BLOOD AND CEREBRO-SPINAL FLUID CHANGES AFTER INTRAVENOUS INJECTION OF HYPERTONIC SOLUTIONS

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Abstract
The authors experimented on human cases of cranial injuries with and without increased intra-cranial pressure, without anesthesia; and on dogs under morphine and amytol. Following preliminary periods of observation, intravenous injections of 15% NaCl solution (90 cc.) and of dextrose solution 25% (100-250 cc.) or 50% (60-125 cc.) were given. Observations were made of cerebro-spinal fluid pressure; sp. gr. of blood or serum or both, and sp. gr. of cerebro-spinal fluid. Barbour and Hamilton''s method was used to determine sp. gr. The cerebro-spinal fluid pressure rose during the injection, falling immediately afterwards to a level considerably below the original. The sp. gr. of the blood and serum fell promptly while the injection was in progress, the lowest point being reached immediately after; then it gradually rose but seldom returned to the original level during the observation period. The sp. gr. of the cerebro-spinal fluid increased after the injection, indicating either water loss or addition of dextrose or NaCl. The authors estimate that the volume of fluid which enters the blood from the tissues varies in man from 300 to 1000 cc. (7-19% of blood volume) and in dogs from 100 to 900 cc. (14-80% of blood volume). They show that the increase in water content of the blood (indicated by the fall in sp. gr.) bears a direct relation to the increase in molar concentration of the blood in terms of the substance injected. They conclude that since dextrose is nearly as efficacious as saline in reducing intra-cranial pressure; and since clinically dextrose is productive of no apparent ill-effects while saline may be, dextrose is preferable to saline for that purpose.

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