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August 9, 1947


JAMA. 1947;134(15):1241. doi:10.1001/jama.1947.02880320031010

Hemoglobinuria is an early complication of severe burns; it results from the rapid destruction of red cells; hemoglobinemia is associated with consequent excretion of free hemoglobin in the urine. Shen and his co-workers1 found gross hemoglobinuria in 9 patients and minimal hemoglobinuria in 2 among 40 patients of the Cocoanut Grove fire who had second and third degree thermal burns involving 15 to 65 per cent of the body area. Damaged renal function, according to Olson and Necheles,2 is similar to that following hemolysis from incompatible blood transfusion, blackwater fever and other hemolytic diseases. The common factor in all these cases was intravascular hemolysis due to the sudden and rapid destruction of red cells or muscle cells. Ross3 stresses that the escape of large quantities of hemoglobin from erythrocytes into the plasma is almost invariably followed by grave symptoms and frequently by death.

Olson and Necheles conducted