Use of Dextran in Hemorrbagic Shock

Abstract

Standardized hemorrhagic shock was produced in 24 dogs (1 hour at 40 mm Hg). The withdrawn blood was replaced by equal volumes of either 6% dextran or dog plasma. Survival rate in the dextran-treated group was 100% and 70% in plasma-treated animals. Dextran infusion resulted in a significantly greater hemodilution and more rapid recovery of blood pressure than plasma infusion. Both substances, however, result in adequate recovery and maintenance of blood pressure. Dextran disappears from the blood in 5-6 days. The period of urinary excretion of dextran is 4-5 days. Rate of regeneration of plasma proteins is not affected adversely by dextran infusion and proceeds at a level adequate to replace disappearing dextran and thus maintain the colloid osmotic pressure of the plasma. Regeneration of hemoglobin and red blood cells is not adversely affected by dextran or plasma infusion. The acidosis of shock was more rapidly corrected by plasma infusion than by dextran infusion. Blood urea N was elevated to a greater extent following plasma infusion but, for both groups, presented essentially normal levels at the end of the experiment. Chemical analysis of the liver, spleen and kidney disclosed the presence of minimal amounts of dextran in these organs 9 and 12 days after infusion. Histochemically, dextran was shown only in a few renal tubules which appeared to be damaged by severe hypotension. Histologic and histochemical changes attributable to dextran were in all cases considered mild and reversible in character.