The Increased Plasma Volume in Cardiac Insufficiency: Its Correlation with Right-sided Failure.

It is now well established that in,cardiac insufficiency there is an increase in the circulating blood volume as calculated by dye methods (1, 2). The mechanism of the rise in the red cell component has been attributed to anoxemia (3); that of the increase in plasma volume has remained obscure. Discrepancies in the different quantitative measurements of cardiac insufficiency are not rare. The occasional appearance of acute right-sided failure without a comparable rise in peripheral venous pressure has been observed in this hospital. In addition, others have noted that the plasma volume rise preceded the venous pressure change in several cardiac patients in whom failure was induced by sodium chloride administration (4). Although a general parallelism between the blood volume, circulation time and venous pressure has been reported (1), other workers were unable to determine any significant relationship between these values (2). Because of the lack of consistent correlation between the various clinical measurements of cardiac insufficiency, the present study was undertaken to determine whether the plasma volume might be related to the degree of circulatory interference in the hepatic and portal vascular beds. This was based on the hypothesis that these areas were larger and more logical sites for the volume increase than the smaller pulmonary and more erratic peripheral circulations.