The Development of a Plasma 

 Volume Expander 



MAX BOVARNICK and MARIANNA R. BOVARN1CK 



The innate and apparently incurable predilection of man for the 

 "letting of blood" in one form or another has presented to the medical 

 fraternity one of its oldest therapeutic problems — the problem of find- 

 ing a substitute for whole blood or its essential components. According 

 to no less an authority on the matter than the biblical record of human 

 history, within the first generation of his appearance on earth man 

 had already succeeded in converting his plowshare into a sword with 

 which he eliminated one-third of the male population of the period. 

 This sort of thing has been going on in one form or another ever since, 

 and constant improvement of human knowledge over the centuries has 

 in no way diminished the magnitude of the problem. On the contrary, 

 modern surgical practice requires the replacement of enormous amounts 

 of blood, and the unbelievable improvement in the science of warfare 

 has threatened to raise the above-mentioned annihilation rate of 33.3% 

 to nearly lOO'/c. It is thought that blood or plasma volume replace- 

 ment on sufficient scale may possibly help to reduce the latter figure. 



Therefore, although it is perfectly obvious that no substitute for 

 blood is likely to be as good as blood itself, the imminent potential 

 magnitude of the replacement problem has stimulated efforts to pro- 

 vide a substitute for plasma in those instances where an insufficient 

 volume of circulating blood threatens to effect vascular collapse and 

 death and where the oxygen-carrying capacity of red blood cells is not 

 needed. 



As a result of the extensive experience gained in World War II it 

 has been possible to formulate a set of criteria for any satisfactory 

 plasma substitute. These are as follows: The material must primarily 

 be able on injection to expand plasma volume by remaining in the 

 blood stream a suitable length of time and exerting an oncotic pressure 



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