Skip to main content
British Medical Journal logoLink to British Medical Journal
. 1971 Dec 18;4(5789):713–716. doi: 10.1136/bmj.4.5789.713

Exchange Transfusion with Dextran 40 in Polycythaemia Secondary to Hypoxic Lung Disease

B D W Harrison, R J Gregory, T J H Clark, G W Scott
PMCID: PMC1799992  PMID: 5129615

Abstract

In eight patients with polycythaemia secondary to hypoxic lung disease 10 elective exchange transfusions were performed to reduce red cell mass, packed cell volume (P.C.V.), and whole blood viscosity. The rationale for reducing P.C.V. is discussed. It is concluded that patients with P.C.V. of 60% or over will benefit from exchange transfusion and that most patients with P.C.V. over 50% and true polycythaemia will also benefit. We also confirm that the technique of exchange transfusion is a rapid, safe, and effective method of achieving large venesections and reducing red cell mass.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. AUCHINCLOSS J. H., Jr, DUGGAN J. J. Effects of venesection on pulmonary and cardiac function in patients with chronic pulmonary emphysema and secondary polycythemia. Am J Med. 1957 Jan;22(1):74–82. doi: 10.1016/0002-9343(57)90338-8. [DOI] [PubMed] [Google Scholar]
  2. Agarwal J. B., Paltoo R., Palmer W. H. Relative viscosity of blood at varying hematocrits in pulmonary circulation. J Appl Physiol. 1970 Dec;29(6):866–871. doi: 10.1152/jappl.1970.29.6.866. [DOI] [PubMed] [Google Scholar]
  3. Burrows B., Earle R. H. Course and prognosis of chronic obstructive lung disease. A prospective study of 200 patients. N Engl J Med. 1969 Feb 20;280(8):397–404. doi: 10.1056/NEJM196902202800801. [DOI] [PubMed] [Google Scholar]
  4. CHAMBERLAIN D. A., MILLARD F. J. THE TREATMENT OF PLYCYTHAEMIA A/CHAMBERLAIN DA, MILLARD FJ: THE TREATMENT OF POLYCYTHAEMIA SECONDARY TO HYPOXIC LUNG DISEASE BY CONTINUOUS OXYGEN ADMINISTRATION. Q J Med. 1963 Oct;32:341–350. [PubMed] [Google Scholar]
  5. Dintenfass L., Read J. Pathogenesis of heart-failure in acute-on-chronic respiratory failure. Lancet. 1968 Mar 16;1(7542):570–572. doi: 10.1016/s0140-6736(68)92836-5. [DOI] [PubMed] [Google Scholar]
  6. Gregory R. J. Technique for treatment of polycythaemia by exchange transfusion. Lancet. 1971 Apr 24;1(7704):858–858. doi: 10.1016/s0140-6736(71)91525-x. [DOI] [PubMed] [Google Scholar]
  7. Gregory R. J. The rapid lowering of haematocrit by exchange transfusion of Rheomacrodex dextran 40. Its use in polycythaemia, cor pulmonale and ischaemic disease. Acta Med Scand. 1971 Jun;189(6):551–554. [PubMed] [Google Scholar]
  8. Hume R. Blood volume changes in chronic bronchitis and emphysema. Br J Haematol. 1968 Aug;15(2):131–139. doi: 10.1111/j.1365-2141.1968.tb01522.x. [DOI] [PubMed] [Google Scholar]
  9. MITCHELL R. S., WEBB N. C., FILLEY G. F. CHRONIC OBSTRUCTIVE BRONCHOPULMONARY DISEASE. III. FACTORS INFLUENCING PROGNOSIS. Am Rev Respir Dis. 1964 Jun;89:878–896. doi: 10.1164/arrd.1964.89.6.878. [DOI] [PubMed] [Google Scholar]
  10. Pengelly C. D. Reduction of haematocrit and red-blood-cell volume in patients with polycythaemia secondary to hypoxic lung disease by dapsone and pyrimethamine. Lancet. 1966 Dec 24;2(7478):1381–1386. doi: 10.1016/s0140-6736(66)90421-1. [DOI] [PubMed] [Google Scholar]
  11. Renzetti A. D., Jr, McClement J. H., Litt B. D. The Veterans Administration cooperative study of pulmonary function. 3. Mortality in relation to respiratory function in chronic obstructive pulmonary disease. Am J Med. 1966 Jul;41(1):115–129. doi: 10.1016/0002-9343(66)90009-x. [DOI] [PubMed] [Google Scholar]
  12. Segel N., Bishop J. M. Circulatory studies in polycythaemia vera at rest and during exercise. Clin Sci. 1967 Jun;32(3):527–549. [PubMed] [Google Scholar]
  13. Segel N., Bishop J. M. The circulation in patients with chronic bronchitis and emphysema at rest and during exercise, with special reference to the influence of changes in blood viscosity and blood volume on the pulmonary circulation. J Clin Invest. 1966 Oct;45(10):1555–1568. doi: 10.1172/JCI105462. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES