THE EFFECTS OF DEXTRAN IN NORMOVOLEMIC AND OLIGEMIC SUBJECTS 1

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Abstract
Although numerous clinical reports on the use of dextran as a macromolecular plasma volume expander have appeared in the literature, measurements of its effects on plasma volume and plasma protein restitution have been few. One liter of 6% dextran was administered intraven. to 8 normal men after the rapid removal of 1 liter of blood. The plasma volume, hematocrit, plasma protein, and plasma and urinary dextran concns. were detd. 1, 6, 12, and 24 hrs., after the administration of dextran. Control observations were made prior to the venesection. The mean increases in plasma volume were 1020, 820, 700, and 860 at 1, 6, 12, and 24 hrs., respectively. The mean increase in circulating protein at the stated periods was 3.3, 15.7, 19.2 and 30.6 g. The plasma dextran concn. was 1160 mg. per 100 ml. at 1 hr. and decreased progressively to 431 mg. per 100 ml. at 24 hrs. The total circulating dextran was 41.5 g. at 1 hr. and decreased to 14.9 g. at 24 hrs. Approx. 25% of the administered 60 g. of dextran was excreted in the urine in 1 hr. and approx. 58% was excreted in 24 hrs. At the end of 24 hrs. about 17% of the administered dextran could not be accounted for and is assumed to have been present extravascularly. One liter of dextran was also administered to 10 convalescent male patients without cardiovascular or renal disease and similar measurements were carried out. The mean increase in plasma volume was 775 and 534 ml. at 1 and 6 hrs., respectively. The plasma dextran concn. and urinary dextran excretion were similar to those cited above. These expts. indicate that dextran is a satisfactory plasma volume expander in oligemic states. Dextran does not inhibit protein restitution; as it leaves circulating protein is progressively added and hemodilution continues.

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