426 ANNUAL REPORT SMITHSONIAN INSTITUTION, 1945 



Table 4. — Osmotic effect of concentrated human serum albumin in increasing 



blood volume 



Increase In blood 

 Conditions of measurement volume per gram 



albumin 



CC 



Estimated from osmotic pressure * 18 



In experimental hemorrhage 2 17 



In clinical shock, after J4-1 hour 3 16 



In clinical shock, after 1-36 hours 4 23 



i Scntchard, Batchelder, and Brown. 



' Heyl, Gibson, and Janeway. 



s Warren, Stead, Merrill, and Brannon. 



« Cournand, Noble, Breed, Lauson, Baldwin, and Richards. 



The results of these osmotic-pressure measurements may be com- 

 pared with the clinical findings of three groups that have made inde- 

 pendent studies on the value of albumin for transfusions, especially in 

 shock. All have determined the water drawn into the blood stream 

 following injection of albumin in man. One group reported that "the 

 average increase" in blood volume (1 hour after injection) "was 17.4 

 cubic centimeters per gram although there was considerable variation 

 between individual experiments." Another reported that "the albumin 

 injected into the circulation is largely retained, providing no further 

 bleeding or exudation of plasma occurs. It is still remaining in the 

 circulation at the end of 6 hours. The albumin retained holds in the 

 blood stream amounts of fluid approximately comparable to its osmotic 

 activity. Thus, in our series, 1 gram of albumin retained resulted 

 in an average increase of plasma volume of 23 cubic centimeters." The 

 third group concluded that "the plasma volume increased 600, 800, and 

 900 cubic centimeters in the patients receiving 50 grams of albumin. 

 The average increase in volume was 16 cubic centimeters for each 

 gram of albumin." These three carefully controlled clinical investiga- 

 tions yielding respectively 17.4, 23, and 16 cubic centimeters drawn 

 into the blood stream of patients per gram of albumin injected must 

 be considered in excellent agreement with the expectation from the 

 osmotic-pressure measurements of 18 cubic centimeters per gram of 

 albumin which forms the basis for the osmotic equivalence of the two 

 blood derivatives, plasma and albumin, being dispensed to the Armed 

 Forces. 



a- AND 0-GLOBULINS AND THE HORMONES, ENZYMES, AND 

 LIPOPROTEINS OF THE BLOOD 



Although the albumins of plasma play far more important roles 

 than the globulins in the control of blood volume, the diverse globulins 

 also perform functions for which they appear to be uniquely designed. 



