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Abstract THE USE of polyvinylpyrrolidone (PVP)1 and of dextran2 has been proposed for increasing the volume of plasma after hemorrhage and for the treatment of shock. Earlier experience with acacia used for this purpose indicated that it impaired liver function.3 In addition, the use of acacia depressed the formation of plasma protein,4 possibly because of its action on the liver. Although dextran and polyvinylpyrrolidone have been used extensively in foreign clinics, there is little specific information concerning possible ill effects on the liver function of man. Bohmansson and co-workers have made some studies of dextran, using for this purpose bile pigment, hippuric acid, and phosphatase determinations. We have extended these studies by means of other liver function tests, including several generally considered to be more sensitive than those used by these workers, and. in addition, have made similar studies of polyvinylpyrrolidone. METHOD The patients studied were those References 1. Hecht, G., and Weese, H.: A New Plasma Substitute , München. med. Wchnschr. 90: 11-15, 1943. 2. Schultz, E.: Blood Transfusion and Blood Substitutes in War , Deutsche med Wchnschr. 67:779-784, 1941.Crossref 3. Flannery, M. M., and Menkin, A.: Polyvinylpyrrolidone , New York, General Aniline and Film Corp., 1951. 4. Grönwall, A., and Ingelman, B.: Untersuchungen über Dextran und sein Verhalten bei parenteraler Zufuhr, I ., Acta physiol. scandinav. 7:97-107, 1944Crossref 5. Untersuchungen über Dextran und sein Verhalten bei parenteraler Zufuhr, II ., Grönwall Acta physiol. scandinav. 9:1-27, 1945.Crossref 6. Ingelman, B.: Investigations on Dextran and Its Application as a Plasma Substitute , Upsala läkaref. förh. 54:107-122, 1949. 7. Bohmansson, G.; Rosenkvist, H.; Thorsen, G., and Wilander, O.: Clinical Experiences with Dextran as a Plasma Substitute , Acta chir. scandinav. 94:149-167, 1946. 8. Lundy, J. S.; Gray, H. K., and Craig, W. M.: Dextran in Supportive Therapy with Comments on Periston and Gelatins , Arch. Surg. 61:55-61, 1950.Crossref 9. Hall, W. K.; Gibson, R. B., and Weed, L. A.: Studies on the Intravenous Injection of Colloids: II. Effects of Gum Acacia on Certain Functions of the Liver with a Note on Its Effects on the Production of Immune Bodies , J. Lab. & Clin. Med. 26:330-339, 1940. 10. Jackson, R. L., and Frayser, L.: The Effect of Acacia on the Blood , J. Pharmacol. & Exper. Therap. 65:440-452, 1939. 11. Nine patients received 1 liter of a preparation of polyvinylpyrrolidone manufactured in Germany and bottled by the Schenley Laboratories, Inc. The intrinsic viscosity of the material was 0.245, the average molecular weight approximately 30,000. The remainder of the patients received polyvinylpyrrolidone manufactured by the General Aniline and Film Corporation. The average molecular weight of this material was 33,000; the K value was 33. Both preparations contained 3.5% of polyvinylpyrrolidone in 0.85% sodium chloride solution. Dextran was supplied by the Commercial Solvents Corporation. It was given as a 5.9% solution. The results of a typical analysis were as follows: viscosity 3.18 centipoises; no precipitation at 45% methyl alcohol; 88% precipitation at 58% methyl alcohol, and 12% precipitation at 80% methyl alcohol. 12. Malloy, H. T., and Evelyn, K. A.: The Determination of Bilirubin with the Photoelectric Colorimeter , J. Biol. Chem. 119:481-490, 1937. 13. Ducci, H., and Watson, C. J.: The Determination of the Serum Bilirubin with Special Reference to the Prompt-Reacting and the Chloroform-Soluble Types , J. Lab. & Clin. Med. 30:293-300, 1945. 14. Reinhold, J. G., and Hutchinson, C.: To be published. 15. Maclagan, N. F.: Thymol Turbidity Test: A New Indicator of Liver Dysfunction , Nature, London 154:670-671, 1944. 16. Kunkel, H. G.; Ahrens, E. H., Jr., and Eisenmenger, W. J.: Application of Turbidimetric Methods for Estimation of Gamma Globulin and Total Lipid to the Study of Patients with Liver Disease , Gastroenterology 11:499-507, 1948. 17. de la Huerga, J., and Popper, H.: Standardized Reagent for Thymol Turbidity Test , J. Lab. & Clin. Med. 34:877-880, 1949. 18. Hanger, F. M.: Serological Differentiation of Obstructive from Hepatogenous Jaundice by Flocculation of Cephalin-Cholesterol Emulsions , J. Clin. Invest. 18:261-269, 1939. 19. Neefe, J. R., and Reinhold, J. G.: Photosensitivity as a Cause of Falsely Positive Cephalin-Cholesterol Flocculation Tests , Science 100:83-85, 1944. 20. von Frijtag Drabbe, C. A. J., and Reinhold, J. G.: Determination of Polyvinylpyrrolidone in Body Fluids by Means of a Turbidity Producing Reaction with Phenol, to be published. 21. Weichselbaum, T. E.: An Accurate and Rapid Method for the Determination of Proteins in Small Amounts of Blood Serum and Plasma , Am. J. Clin. Path. 10:40-49, 1946. 22. Majoor, C. L. H.: The Possibility of Detecting Individual Proteins in Blood Serum by Differentiation of Solubility Curves in Concentrated Sodium Sulfate Solutions: Comparison of Solubility Curves with Results of Electrophoresis Experiments , J. Biol. Chem. 169:583-594, 1947. 23. Watson, C. J.; Schwartz, S.; Sborov, V., and Bertie, E.: Studies of Urobilinogen: A Simple Method for the Quantitative Recording of the Ehrlich Reaction as Carried out with Urine and Feces , Am. J. Clin. Path. 14:605-615, 1944. 24. Watson, C. J., and Schwartz, S.: A Method of Separating Small Quantities of the Coproporphyrin Isomers I and III , Proc. Soc. Exper. Biol. & Med. 44:7-10, 1940. 25. Bonsnes, R. W., and Taussky, H. H.: On the Colorimetric Determination of Creatinine by the Jaffe Reaction , J. Biol. Chem. 158:581-591, 1945. 26. Zamchek, N.; Chalmers, T. C., and Davidson, C. S.: Pathologic and Functional Changes in the Liver Following Upper Abdominal Operations , Am. J. Med. 7:409, 1949.Crossref 27. Neefe, J. R.; Kurtz, C. H.; Smith, H. D.; Reynolds, H. M.; Gambescia, J. M., and Reinhold, J. G.: Technique Book of the Hospital of the University of Pennsylvania , Philadelphia, University of Pennsylvania Press, 1951. 28. Neefe, J. R., and Reinhold, J. G.: Laboratory Aids in the Diagnosis and Management of Infectious (Epidemic) Hepatitis , Gastroenterology 7:393-413, 1946 29. Studies of Responses of Certain Hepatic Tests in Diseases of the Liver and Biliary Tract , Neefe Gastroenterology 9:656-671, 1947. 30. Fisher, R. A.: Statistical Methods for Research Workers , Ed. 6, London, Oliver and Boyd, Ltd., 1936.
A.M.A. Archives Surgery – American Medical Association
Published: Nov 1, 1952
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