A Comparison of Plasma Substitutes (Dextran, Polyvinylpyrrolidone and Oxypolygelatin) With Saline Therapy in Treatment of Experimental Tourniquet and Burn Shock in Mice

Abstract

The acute toxicities of 5 different prepns. of dextran (6%), 1 modified gelatin (5% oxy-polygelatin), and 2 different polyvinylpyrrolidone prepns. (3.5%) were detd. in normal mice by the intraven. admn. of 1 ml. doses at 1- to 2-hr. intervals. A standardized traumatic shock produced by burns or tourniquets was employed which was fatal to over 90% of untreated mice. Therapy comprised 5% body wt., admd. within an hr. after the trauma either in a single 1 ml. dose or 4 divided doses at intervals of 2 hrs. The compounds were admd. in 0.9% NaCl or 5% glucose and compared simultaneously on a mortality basis with mice receiving saline or glucose alone. In shocked mice on a mortality basis no therapeutic effect from some of these prepns., when admd. in single doses, could be demonstrated when compared to glucose or saline-treated controls employed alternately in the same expts. With other prepns. the tolerance in shocked mice was considerably reduced particularly in burned animals. This was manifest by an increased mortality above that of control groups treated with saline. Under conditions of divided-dose admn. in which plasma or serum was demonstrably superior to saline, similar variations in the response to the various plasma substitutes were observed. Normal mice tolerated volumes of plasma substitutes equivalent to 5 and 10% body wt. without effect, while 6 animals out of a total of 78 died following the admn. of volumes equivalent to 15% body wt. Pathologic lesions observed in untreated or saline-treated burned animals were characterized by a spotty tubular dilation attributable to plugging of tubules by hemoglobin casts, whereas those lesions observed in burned animals receiving dextran were characterized by a diffuse tubular dilatation and no hemoglobin casts. The presence of dextran within these dilated tubules was identified histo-chemically. No differences in the blood NPN values were observed between the burned animals receiving dextran or saline.