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[State of circulating blood volume, blood components and the function of external respiration in lung cancer].

The data concerning the changes in the circulating blood volume, globular and plasma volumes, red blood cells indices and also some indices of the external respiration function in lung cancer cases are set forth. Radiopneumography has permitted to find out some significant disorders in the regional ventilation and in the pulmonary blood flow in early postoperative period, which in case of hypoventilation is likely to cause a severe respiratory insufficiency and, therefore, requires an energetic therapeutic control.

Adult

Effects of subarachnoid hemorrhage on cerebral blood volume, blood flow, and oxygen utilization in humans.

Forty-five studies of regional cerebral blood volume (rCBV), regional cerebral blood flow (rCBF), and regional cerebral oxygen utilization (rCMRO2) were performed in 30 patients undergoing diagnostic cerebral angiography for evaluation of a subarachnoid hemorrhage due to a ruptured intracranial aneurysm. Tracer methods employing radioactive oxygen-15 were used to measure rCBV, rCBF, and rCMRO2. The patient studies were divided into groups based on their neurological status and the presence or absence of cerebral vasospasm. Subarachnoid hemorrhage, with and without vasospasm, produced significant decreases in CBF and CMRO2. In general, patients with more severe neurological deficits, and patients with more severe degrees of vasospasm, had a more marked depression of CBF and CMRO2. The most striking finding was a significant (p less than 0.001) increase in CBV (to 58% above normal) in patients with severe neurological deficits associated with severe cerebral vasospasm. This large increase suggests that cerebral vasospasm consists of constriction of the large, radiographically visible extraparenchymal vessels accompained by a massive dilation of intraparenchymal vessels.

Blood Pressure

Plasma volume, blood volume and transcapillary escape rate (TER) of albumin in young spontaneously hypertensive rats (SHR) as compared with normotensive controls (NCR).

A detailed comparison of blood and plasma volumes and of the transcapillary escape rate (TER) of albumin was performed in SHR and matched NCR, particularly during the phase of rapid pressure rise in SHR. Throughout this early phase of life, the relative plasma and blood volumes tend to be lower, and TER higher in SHR, as would be expected when neurogenic mechanisms dominate the initiation of hypertension. Only in late established SHR hypertension, with increasing signs of cardiovascular complications, blood volume tends to be higher in SHR than in NCR. These results are in general agreement with most observations in early essential hypertension in man. They are of interest in contrast to recent findings in another variant of primary hypertension in rats, MHS. Also the apparently quite different initiating mechanisms in SHR and MHS primary hypertension are discussed.

Animals

Effects of increased intracranial pressure on cerebral blood volume, blood flow, and oxygen utilization in monkeys.

The relationship of cerebral blood volume (CBV) to cerebral perfusion pressure (CPP), cerebral blood flow (CBF), and the cerebral metabolic rate for oxygen (CMRO2) was examined in rhesus monkeys. In vivo tracer methods employing radioactive oxygen-15 were used to measure CBV, CBF, and CMRO2. Cerebral perfusion pressure was decreased by raising the intracranial pressure (ICP) by infusion of artificial cerebrospinal fluid (CSF) into the cisterna magna. The production of progressive intracranial hypertension to an ICP of 70 torr (CPP of 40 torr) caused a rise in CBV accompanied by a steady CBF. With a further increase in ICP to 94 torr, CBV remained elevated without change while CBF declined significantly. Cerebral metabolic rate for oxygen did not change significantly during intracranial hypertension. For comparison, CPP was lowered by reducing mean arterial blood pressure in a second group of monkeys. Only CBF was measured in this group. In this second group of animals, the lower limit of CBF autoregulation was reached at a higher CPP (CPP approximately to 80 torr) than when an increase in ICP was employed (CPP approximately to 30 torr).

Animals

Peripheral circulation in the newborn: interaction of peripheral blood flow, blood pressure, blood volume, and blood viscosity.

Peripheral blood flow and systolic blood pressure (strain-gauge plethysmograph), blood volume (Evans blue) and whole blood viscosity (cone-plate viscometer) have been measured in 66 premature and full-term infants 6 to 144h of age. Blood flow and blood volume were moderately decreased in the infants with respiratory distress. Highly significant (P less than 0.001) correlations were found between blood flow and blood volume (r = 0.77), blood pressure and blood volume (r = 0.50), peripheral resistance and blood volume (r = -0.44), blood flow and blood pressure (r = 0.50), blood flow and peripheral resistance (r = -0.67), peripheral resistance and blood viscosity (r = 0.45), and blood viscosity and haematocrit (r = 0.86). There was no correlation between peripheral blood flow and blood viscosity. However, at given blood volume, peripheral blood flow decreased with increasing blood viscosity. These results indicate that in newborn infants peripheral blood flow, blood pressure and peripheral resistance are influenced by blood volume, but also depend on blood viscosity.

Blood Circulation

Measurement of blood loss by total-body counting on the basis of calculated and predicted blood volumes.

Blood loss was measured by total-body counting in conformity with the fall in activity, the calculated or predicted blood volumes being known. On the ground of the predicted and calculated blood volumes it was the Nadler formula which gave the best approximation. The method was employed for the measurement of blood loss in users of intrauterine contraceptive spirals. It was found suitable for the measurement of a sudden blood loss of major intensity.

Adult

Prediction of the normal blood volume. Relation of blood volume to body habitus.

Predictions of blood volume (BV) assume the existence of a constant ratio between BV and body weight or surface area (SA). We examined the validity of this assumption by calculating BV from plasma volume and body hematocrit in 160 normal volunteers whose weights ranged from -38.7 to 210.8% of desirable weight (assessed by a modification of the Metropolitan Life Insurance Company Desirable Weight tables). BV is not a constant fraction of body weight or SA in this population. Its prediction from such constant ratios results in a large error of estimate which is systematically biased with respect to height and weight. BV prediction from the observed regressions of the parameter on weight and SA reduces the error substantially but remains biased with respect to height. BV prediction from the subject's degree of deviation from desirable weight affords a smaller error of estimate which is apparently free from systematic bias.

Adult

Blood volume and blood pressure in infants with respiratory distress.

Mean aortic blood pressure volume were measured in true premature infants with respiratory distress syndrome. Seven infants had Type I RDS (hyaline membrane disease) and ten had transient tachypnea of the newborn (Type II RDS). Blood volume in the infants with Type I RDS was significantly lower than in the infants with Type II RDS. The difference was due to a low red cell volume. Mean aortic blood pressure was within the range of normal in all infants and therefore did not reflect the low blood volume of infants with Type I RDS. Normal mean aortic blood pressure does not indicate normal blood volume or normal circulation in infants with RDS.

Aorta, Abdominal

Capillary-venous hematocrit differences in newborn infants. I. Relationship to blood volume, peripheral blood flow, and acid base parameters.

Venous and capillary hematocrit, acid base values, and circulatory parameters were measured simultaneously in 92 newborn infants within six hours of birth. Gestational age ranged from 26 to 41 weeks. The capillary/venous hematocrit ratio (Hctc/Hctv) was greater than 1.00 in 89 infants. We found significant inverse correlations between Hctc/Hctv and several parameters, such as pH (r = -0.82), standard bicarbonate (r = -0.73), systolic blood pressure (r = -0.51), and peripheral blood flow (r = -0.70). Most of the infants with a Hctc/Hctv of 1.20 and above had red cell mass values of less than 35 ml/kg. However, blood volume apparently did not influence the Hctc/Hctv. Gestational age appeared to affect Hctc/Hctv only before 30 weeks, when compared with the Hctc/Hctv of term infants. Our results indicate that disturbed circulation, and in particular, disturbed microcirculation is involved in the development of high Hctc/Hctv ratios. We strongly advise that hematocrits obtained by skin prick from a sick newborn infant should not be relied on as they may give misleading information on oxygen carrying capacity to vital organs.

Acid-Base Equilibrium

Blood volume and arterial blood gases in patients with chronic obstructive lung disease during and after acute respiratory failure.

The blood volume and arterial blood gases of 18 patients with chronic obstructive lung disease were studied over a period of 1/2 to 5 years, including 35 acute exacerbations of the lung disease. Treatment during exacerbation was directed at infection, bronchial obstruction and hypervolemia. Long-term diuretic therapy was instituted during the follow-up period. On admission all patients suffered from severe dyspnoea, all but two had signs of peripheral oedema and/or liver congestion and one-third had increased jugular venous pressure. Blood volume was increased in all patients and eight of them had a hematocrit above 50%. PaCO2 was severely reduced and PaCO2 increased on admission. At discharge, these symptoms and signs had all diminished or disappeared. Blood volume had fallen an average of 11 and a further reduction of 0.41 was noticed during the follow-up period. Blood gases had improved by discharge and a further improvement accompanied the reduction of blood volume during the follow-up period. It is suggested that 1) hypervolemia is common in patients with advanced chronic obstructive lung disease; 2) hypervolemia may impair arterial oxygenation; 3) long-term diuretic therapy seems to be necessary for maintaining a normal blood volume.

Adult