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Blood volume changes during treatment of protein-calorie malnutrition
Insights
Children recovering from protein-calorie malnutrition showed low blood volume. During recovery, plasma volume increased more than red cell volume, leading to hemodilution.
Area of Science:
- Pediatrics
- Hematology
- Nutrition Science
Background:
- Protein-calorie malnutrition (PCM) significantly impacts child development and physiological functions.
- Understanding fluid and electrolyte balance is crucial for managing malnutrition recovery.
- Hematological parameters are often altered in malnourished children.
Purpose of the Study:
- To sequentially assess intravascular volumes in African children during recovery from PCM.
- To compare red cell volume, plasma volume, and total blood volume relative to body size.
- To investigate changes in volemia during the realimentation process.
Main Methods:
- Sequential determination of intravascular volumes in 13 African children.
- Radiochromium technique used for red cell volume measurement.
- Calculation of total blood volume and plasma volume, related to body size.
Main Results:
- Initially, total blood volume was low per body size, with red cell volume more reduced than plasma volume.
- After 20 days of realimentation, total blood volume normalized, but red cell volume increased less than plasma volume.
- By day 60, total blood volume was normalized, but red cell volume remained low with supranormal plasma volume, indicating hemodilution.
Conclusions:
- Rehabilitation from PCM in children is associated with progressive hemodilution.
- Plasma volume expansion outpaces red cell volume increase during recovery.
- Altered volemic status during recovery requires careful consideration due to changing body composition.
Abstract:
Intravascular volmes were sequentially determined in 13 African children recovering from protein-calorie malnutrition. The red cell volume was measured by a radiochromium technique; the total blood volume and the plasma volume were calculated. The absolute volumes were related to body size and were compared with the control values. Before treatment, the total blood volume was low per unit of body size, the red cell volume was more reduced than the plasma volume. On the 20th realimentation day, the absolute red cell volume had increased less than the absolute plasma volume, the total blood volume was almost normal per unti of body size. On the 60th realimentation day, near recovery, the absolute red cell volume had again increased, but again less than the absolute plasma volume, and the venous hematocrit was lower than on admission; the total blood volume was normalized per unit of body size, the red cell volume was low with a supranormal plasma volume. The rehabilitation period was characterized by an aggravation of the hemodilution already present before treatment. The significance of the changes in volemia per unit of body size was unclear because of the changing body composition.