Influence of tonicity on the viscoelastic properties of blood during isovolemic dilution

The influence of isotonic or hypotonic dilution on viscoelastic properties of blood is examined. The viscous, as well as the elastic, properties of blood samples diluted with isotonic saline or pure water, respectively, and of undiluted whole blood samples are compared by means of a dynamic capillary viscosimeter (OCR-D, A. Paar K.G., Austria). The dilution (approximately 17% of the total blood volume) was performed isovolemically and retained the same rbc count. The rbc swelling observed as a consequence of changes in plasma osmolarity was tracked by the high resolution density measurement, according to the mechanical oscillator technique. Since no significant rbc swelling was found in the dilution with isotonic saline, viscoelastic resistance of blood was efficiently reduced in the observed range of shear rates (2 s-1-100 s-1). This decrease is due to reduced plasma protein concentration, which also lowers plasma viscosity by approximately 18%. Although plasma viscosity is significantly decreased in hypotonic dilutions (-12%), flow properties of the rbc suspensions are, in general, significantly impaired. This is due to the osmotic rbc swelling (hematocrit = +8%), which increases viscous resistance within the suspending fluid, as well as elastic resistance of the rbc due to a loss in rbc deformability. It can be concluded that isotonic dilution leads to a decrease in the viscosity of blood, whereas hypotonic dilution--in an order of magnitude which may occur during resorption of water--leads to increased viscous and elastic resistance of the blood.