CHEMICAL, CLINICAL, AND IMMUNOLOGICAL STUDIES ON THE PRODUCTS OF HUMAN PLASMA FRACTIONATION. VII. CONCENTRATED HUMAN SERUM ALBUMIN 123

Abstract

Concentrated human serum albumin was developed to meet the needs of mobile military groups for a compact, stable, quickly available blood substitute for emergency use. The standard Army and Navy package contains 25 gs. of albumin in 100 ml. of diluent, and is equivalent to 500 ml. of citrated plasma in osmotic effect. When injected, it draws fluid rapidly into the circulation and has been successfully used in civilian hospitals to restore blood vol. in 91 cases of shock due to trauma, hemorrhage, operations, and burns. Properly processed albumin does not produce reactions. Pyrogenic reactions were encountered in trials of certain lots, which were therefore rejected until the albumin was reprocessed to a satisfactory state. No evidence of sensitization to either native or heated albumin (50[degree] C. for varying periods) was found. Neither clinical nor pathologic evidence of damage from repeated albumin irijns. was observed, except in one case in which pulmonary edema was attributed to overdosage (650 gs. of albumin containing 1:10,000 merthiolate in 5 days). Albumin did not appear in the urine after inj. unless there was proteinuria, nor was its inj. followed by an increase in urinary NPN. in hypoproteinemic patients, indicating storage, since only a small portion of the injected albumin could be accounted for in the circulation. Very large amts. given in doses of 25 gs. daily were needed to produce an appreciable rise of serum albumin conc. in patients with chronic hypoproteinemia. In cirrhosis of the liver, albumin raised the serum albumin level but did not produce lasting benefit. In nephrotic patients, the injected albumin was largely excreted in the urine as protein; diuresis did not regularly result from albumin treatment but occurred coincidentally in 2 cases. There was little opportunity to treat patients with acute hypopro- teinemia, but the results in a few cases suggest that albumin will be most useful in this group.