THE EFFECT OF CRYSTALLOIDAL AND PROTEIN-CONTAINING SOLUTIONS ON THE BODY FLUIDS AND CIRCULATING PLASMA PROTEINS

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Abstract
Normal saline effected a temporary rise in plasma volume, most of which decreased after 3 hrs.; this marked passage of fluid did not carry any appreciable amt. of protein with it; almost all of the injd. fluid was to be accounted for, at the end of 3 hrs., in the extracellular space (by far predominantly the interstitial spaces) and in the increased urine output; there was no significant alteration in the cellular fluids following the inj. With 5% glucose, there was a less striking increase in the plasma vol., which completely disappeared by the end of 2 1/2 hrs. This rapid loss of fluid also failed to cause any loss of protein from the circulation. The extracellular space accommodated a small amt. of the injd. fluid at the end of 2 1/2 hrs., but a considerable quantity also entered the cells, presumably because the cell membrane was permeable to the glucose molecule. 5% glucose produced a quick and marked diuresis which accounted for over half of the injd. fluid at the end of 2 1/2 hrs. Although hypertonic glucose produced a quick and very temporary increase in plasma volume, the methods employed for detn. of plasma volume did not demonstrate this change in most cases. 29 min. after the completion of the injn., the increase was very slight and by 3 hrs. the plasma volume was less than normal. It is suggested that the extracellular compartment is increased by withdrawing fluid from the cells. These body fluids do not appreciably affect the circulating plasma proteins. Due to the diuresis produced by the small quantity of fluid, 50% glucose is actually dehydrating to cells and to interstitial fluids. Normal plasma and hypertonic plasma had a quick and sustained effect in increasing the plasma volume. The increase was proportionately the same in each instance depending upon the amt. of protein injd. In neither case was the volume increase 100% of the theoretical, and similarly there was some disposition of a part of the injd. protein, the location of which is unknown. While normal plasma characteristically produced an increase in the extracellular fluid as a result of fluid volume injd., the same effect was obtained by hypertonic plasma, presumably by withdrawing fluid from the interstitial fluids and from the cells.