Abstract
1. 1. Rapid exchange of homologous blood in dog or man may precipitate a state of shock. The reaction is dose-related and becomes more pronounced with increasing duration. 2. 2. Severe hypovolemia (diminution of the effective circulating blood volume) results from sequestration of both plasma and cells. 3. 3. Eventual return of a portion of the trapped blood is evident from repetitive blood volume studies. 4. 4. Separate exchange of components of homologous blood did not eliminate the manifestations of the syndrome in the experimental animal. However, erythrocytes reconstituted in physiologic saline solution caused the least dynamic alterations. 5. 5. Data obtained during clinical exchange of homologous erythrocytes and saline are presented. 6. 6. Amelioration of the homologous blood syndrome during cardiopulmonary bypass has been obtained by (a) reduction of the extracorporeal priming volume, (b) substitution of electrolyte solutions for a portion of the homologous blood and (c) reutilization of blood collecting in pleural and precardial spaces during surgery. 7. 7. Possible etiologic mechanisms of the homologous blood syndrome are discussed.
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