CHEMICAL, CLINICAL, AND IMMUNOLOGICAL STUDIES ON THE PRODUCTS OF HUMAN PLASMA FRACTIONATION. VIII. CLINICAL USE OF CONCENTRATED HUMAN SERUM ALBUMIN IN SHOCK, AND COMPARISON WITH WHOLE BLOOD AND WITH RAPID SALINE INFUSION 12

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Abstract
Concentrated human albumin soln. has been administered in 12 clinical cases of traumatic injury in varying degrees of shock, with measurements of the circulation before and after this treatment. In patients who were not actively bleeding, or losing plasma into burned tissues or peritoneum, the albumin was well retained in the blood. In 9 cases (including 3 burns), an avg. of 62 gs. of albumin was given and an avg. of 43 gs. retained. The albumin tended to remain in the circulating blood for at least 6 hrs., when there was no continued blood or plasma loss at the site of injury. Albumin therapy was effective in producing recovery from shock. It increased right auricular pressure, arterial pressure, and cardiac output. Compared with treatment by whole blood transfusion, albumin therapy brought about a relatively larger cardiac output during recovery from shock. In cases of shock due to skeletal trauma or to hemorrhage, where hemodilution is regularly found, this increased cardiac output is a compensatory effect, since the tissues can receive adequate O2 only by more rapid circulation of the diminished amt. of Hb in the blood. The persistence of acute anemia in many cases, after albumin therapy, suggests that whole blood should be given subsequently, when available.