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Robert Elman, M.D.
AMA Arch Surg. 1952;65(6):805-807. doi:10.1001/archsurg.1952.01260020799001.
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IN OPERATIONS of election it is now fairly commonplace to correct blood deficits by transfusion before operation rather than to wait and transfuse only in case of circulatory impairment during or after operation. Pronounced loss of weight leads to a deficit in both the red cell mass and the total circulating plasma proteins, a conclusion based on many careful blood volume measurements which have shown considerable reductions despite normal routine laboratory reports. Indeed, many surgeons do not hesitate to use blood transfusions in preparing severely malnourished patients even if the red counts and hemoglobin concentrations are normal.

That advancing age in adult surgical patients may be associated with a blood deficit is suggested from the blood volume studies by Beling and his co-workers in a recent number of Geriatrics.1 These workers employed the standard Evans blue (T-1824) and hematocrit technic. In a preliminary survey apparently in an unselected group


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