Possible role of red cell deformability and microvasculature in microcirculation

The roles of the deformability of red blood cells (RBC) and the microvasculature in the maintenance of blood flow were investigated in terms of the pressure (P)-flow rate (Q) relationships in human RBC suspension perfusions of bullfrog hind limb. Although isotonicity for the bullfrog is approximately 215 mOsm/kgH2O, perfusions in intact hind limbs showed no change in the P-Q relationship at test solution osmolalities ranging from approximately 150 to approximately 300 mOsm/kgH2O. The deformability of RBC was examined in glutaraldehyde-fixed hind limbs. Perfusion of fixed limbs with RBC suspension revealed minimum resistance to flow at osmolalities of approximately 250 to approximately 420 mOsm/kgH2O, whereas the same experiment in intact limbs revealed minimum flow resistance at osmolalities of approximately 200 to approximately 300 mOsm/kgH2O. It was noteworthy that the reduction of RBC deformability was not observed in intact limbs at osmolalities of approximately 250 to approximately 200 mOsm/kgH2O. Heinz body-forming RBC from a patient with unstable hemoglobin (Hb) disease (Hb Yokohama) exhibited a marked reduction in deformability as compared with normal RBC in fixed limbs, while there was no discernible difference between the two types of RBC in intact limbs, thereby suggesting that the microvascular bed can compensate, to an appreciable extent, for the impaired deformability of RBC, probably via its distensibility and/or a wall effect. The present study has considerable implications concerning the link between in vitro experiments and the in vivo situation, including the hemodynamic characteristics of RBC suspensions such as the effective viscosity.