STUDIES OF HEMOGLOBINEMIA AND HEMOGLOBINURIA PRODUCED IN MAN BY INTRAVENOUS INJECTION OF HEMOGLOBIN SOLUTIONS

Abstract

[longdash]Intravenous injs. of stroma-free human Hb solns. were made in normal individuals and in patients with preexisting albuminuria in order to study certain aspects of hemoglobinemia and hemoglobinuria in man. From 1.3 to 16.4 gs. of dissolved Hb were injected. Quantitative studies of the plasma Hb after injs. revealed that hemoglobinuria did not appear in normal individuals at plasma Hb levels of less than 100 mg. per 100 cc. and usually did appear with levels appreciably above this value. When hemoglobinuria did occur, less than 15% of the Hb injected appeared in the urine. Protein other than Hb, presumably albumin, usually appeared together with Hb in the urine. Traces of Hb appeared in the urine when plasma Hb levels of 40-50 mg. per 100 cc. were induced in patients with preexisting albuminuria. The urea clearance was not affected during hemoglobinuria. The mechanism of excretion of Hb by the kidneys was discussed. The plasma bilirubin always increased after the Hb inj., the amt. of increase being roughly proportional to the amt. of Hb injected. There were usually no untoward reactions; the largest doses of Hb, namely 9.9 and 16.4 gs., produced abdominal cramps, and in one case a slight febrile reaction. The spleen and liver did not become palpable in any instance. Information concerning the pathologic physiology of certain clinical syndromes associated with hemoglobinemia and hemoglobinuria can be obtained by comparison of the findings in cases with these syndromes with those of the present study.