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Plasma proteins and cardiac oedema

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ThomsonWAR_1933redux.pdf (17.58Mb)
Date
1933
Author
Thomson, William A. R.
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Abstract
 
 
One of the factors in the causation of cardiac oedema is a depletion of the plasma proteins which results in a fall in the colloid osmotic pressure of the blood. This depletion is due principally to malnutrition, and it is suggested that cases of cardiac oedema should be given diets containing the maximum amount of protein compatible with the digestive functions of the patients The results are recorded of an investigation of the plasma proteins in sixty-five patients, consisting of twenty -three cases of heart failure with oedema, sixteen cases of heart disease unaccompanied by oedema, eight cases of Bright's disease, five cases of tuberculosis, two cases of ovarian carcinoma with gross ascites, a miscellaneous group of eight cases and three junior members of the hospital staff who were used as "normals". In all ninety -one estimations were made. The protein content of the oedema fluid in these cases was estimated on twenty -nine samples. There is a distinct diminution in the plasma proteins in cardiac oedema, 87.5 per cent. of the cases having a plasma albumin content of less than 3.2 gm. per cent., while 91 per cent, have a colloid osmotic pressure of the blood below 29 cm of water. In heart disease without oedema there is only a slight diminution in the plasma proteins as compared with the normal, 87 per cent. of the cases having a plasma albumin level greater than 3.2 gm. per cent., and 91 per cent. having a colloid osmotic pressure greater than 29 cm. of water. In view of these findings it is suggested that plasma protein deficiency plays an important role in the aetiology of cardiac oedema. The origin, functions and variations of the plasma proteins are discussed in relation to their role in the production of oedema. The main cause for the plasma protein depletion in cardiac oederna is shown to be malnutrition. In view of this latter finding it is suggested that the dietary of patients with cardiac oedema should contain the maximum amount of protein compatible with their digestive powers.
 
URI
http://hdl.handle.net/1842/34238
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  • Edinburgh Medical School thesis and dissertation collection

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