Hemoconcentration induced by surface hypothermia in infants

The effects of surface hypothermia (25 degrees C) on arterial hematocrit value (by microcentrifuge) and plasma protein concentration (by refractometry) were studied in infants undergoing surface cooling for cardiac operations. To analyze in detail the mechanisms leading to the observed changes in patients, we performed parallel studies on normal dogs and permanently splenectomized dogs. In these dogs, measurements were also made of plasma volume (by 125I-albumin) and red cell volume (by 51Cr-erythrocytes). Arterial hematocrit value increased progressively during surface cooling in infants. Assuming that red cell volume remained constant and that the ratio of whole body red cell percentage to arterial hematocrit value during surface cooling in infants as in splenectomized dogs, we estimated percent changes in plasma volume in infants from arterial hematocrit data. The computed plasma volume decreased progressively as the body temperature was decreased. Since plasma protein concentration remained constant, the loss of plasma volume suggested a sequestration of whole plasma in portions of the circulatory bed and/or an extravasation of whole plasma into the interstitial space.