MAXIMAL HEMOGLOBIN AND PLASMA PROTEIN PRODUCTION UNDER THE STIMULUS OF DEPLETION

The maximal output ceiling for hemoglobin in anemia due to blood loss is about 60 gm. per week—the dog receiving a rich protein diet plus high iron intake. Ferrous and ferric salts are equally effective. Iron intravenously plus a rich protein diet may push this level up to 90 to 100 gm. per week. Evidently iron absorption is a limiting factor. Maximal output for hemoglobin plus plasma protein in doubly depleted dogs may reach 120 to 130 gm. per week and using intravenous iron may reach 140 to 160 gm. per week. Maximal output for plasma protein alone in hypoproteinemia due to plasmapheresis reaches 60 to 70 gm. per week but this is not the true ceiling. Technically we cannot remove the new plasma protein as fast as it is formed and the hypoproteinemia is not maintained in the face of a rich protein diet intake. Furthermore the evidence points to the protein circulating pool contributing to the accretion of tissue protein in such dogs with a strong positive nitrogen balance and weight gain. Maximal figures for hemoglobin production in anemia run close to 1 gm. hemoglobin per kilo per day. Maximal figures for new hemoglobin plus plasma protein production in anemia and hypoproteinemia using iron given intravenously, may reach 1.5 gm. blood protein per kilo per day. The actual maximal plasma protein production equals about 1 gm. per kilo per day but the true production ceiling cannot be reached by this technique, for reasons given above.