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Alterations of capillary flow during sepsis.
Circulatory Shock
|January 1, 1985
Summary
Sepsis significantly reduces red blood cell deformability, making them more rigid. This impaired flexibility may contribute to reduced blood flow and microcirculatory issues in septic patients.
Area of Science:
- Hematology
- Critical Care Medicine
- Pathophysiology
Background:
- Normal red blood cells (RBCs) possess flexibility crucial for navigating narrow capillaries.
- Impaired RBC deformability (RCD) is associated with conditions like uremia, peripheral vascular disease, and diabetes.
Purpose of the Study:
- To investigate the presence and extent of impaired RBC deformability in patients experiencing sepsis.
- To determine if altered RBC mechanics contribute to the pathophysiology of sepsis.
Main Methods:
- Compared RCD in citrated whole blood (WB) and buffy coat-poor blood (BCP) from 10 septic patients versus 10 matched controls.
- Utilized polycarbonate 5-micron pore filters and measured blood flow under controlled pressure (-10 cm H2O).
- Calculated a red cell deformability index based on flow volume and hematocrit.
Main Results:
- Septic patients exhibited significantly decreased flow in both WB and BCP samples compared to controls.
- Reduced flow in BCP blood strongly suggests diminished intrinsic RBC deformability in sepsis.
- Decreased RBC deformability in sepsis could explain observed arteriovenous (AV) shunting and reduced microcirculatory flow.
Conclusions:
- Sepsis is associated with significantly impaired red blood cell deformability.
- Increased red blood cell rigidity in sepsis may be a key factor in microcirculatory dysfunction.
- Findings suggest RCD as a potential therapeutic target in managing sepsis-related complications.