That the total circulating blood volume is increased during congestive heart failure1 and is decreased after recovery1b,c has been convincingly demonstrated. Knowledge is incomplete, however, in regard to the mechanisms involved in creating and in disposing of the increased circulating volume of erythrocytes and plasma during the different stages of congestive failure. In the present investigation the reticulocyte percentage, red cell fragility, serum bilirubin and urinary and fecal excretion of pigment were studied in a series of patients at intervals during the height of, and recovery from, congestive heart failure; these findings were related to the observed changes in blood volume and clinical status.
The total blood volume, plasma and circulating red blood cell mass were ascertained by means of Evans blue dye and the photoelectric colorimeter, as described by Gibson and Evans2 and Gibson and Evelyn.3 Measurements were made soon after the patient's admission to the hospital and
WALLER JV, BLUMGART HL, VOLK MC. STUDIES OF THE BLOOD IN CONGESTIVE HEART FAILURE: WITH PARTICULAR REFERENCE TO RETICULOCYTOSIS, ERYTHROCYTE FRAGILITY, BILIRUBINEMIA, UROBILINOGEN EXCRETION AND CHANGES IN BLOOD VOLUME. Arch Intern Med (Chic). 1940;66(6):1230–1245. doi:10.1001/archinte.1940.00190180042004
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