Clinical Hemorheology and Microcirculation - Volume 16, issue 3

Authors: Uberos, J. | Muñoz, A. | Molina, A. | Valenzuela, A. | Ruiz, C. | Narbona, E. | Molina Font, J.A.

Article Type: Research Article

Abstract: The physiological weight loss in the newborn has been related to the elimination and the low ingestion of liquids in the first days oflife. The degree of weight loss, generally less than 10% of the birth weight, is related to the resolution in higher or lesser degree of neonatal edema and an adequate administration of liquids to the newborn. The following study was done to test the hypothesis that the physiological weight loss in the newborn could be related to homeostatic situations before delivery, which would determine the fluid balance in the first few days of life. We analyzed the …relationship between plasma viscosity and blood density of cord blood with weight loss in the first 48 hours of life. Twenty-six healthy newborns of gestational ages between 259 and 296 days (278 ± 8, mean ± SD) were studied. The following parameters were determined in the umbilical artery and vein: haematocrit, blood density, plasma viscosity and osmolality. Blood gas parameters were determined using a blood gas analyzer. We determined the weight of the newborn at birth and after 48 hours. We did not find significant differences between the arterial and venous blood densities, with a density in the umbilical artery of 1.05 ± 0.01 g/ml and 1.06 ± 0.03 g/ml in the umbilical vein. The weight loss in the first 48 hours in the newborn was 151 ± 80.8 g, with a birth weight of 3325 ± 414 g. Our results suggest that decrease of body liquid volume in the fetus is accompanied by an increase in plasma viscosity which could produce a decrease of the neonatal diuresis with less physiological weight loss in the newborn after delivery. This event is related to a decrease offetal plasma bicarbonate. Show more

Keywords: Blood density, Umbilical cord, Newborn, Plasma viscosity, Blood rheology, Weight

DOI: 10.3233/CH-1996-16301

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 229-234, 1996

Authors: Vayá, Amparo | Martínez, Marcial | Labios, Manuel | Guiral, Victoria | Llopis, Ines | Aznar, Justo

Article Type: Research Article

Abstract: In 150 healthy offspring (70 male and 80 female) of hypertensive individuals (I-II OMS degree), the hemorheological profile was determined: Whole blood filterability (WBF), rigidity index (RI), erythrocyte aggregation (EA), blood viscosity (BV), plasma viscosity (PV), fibrinogen (Fbg), hematocrit (Ht) and leucocyte count (Leuc). The control group was made up of an equal number of healthy well matched individuals with normotensive parents. A significant increase in the Fbg level with respect to the control group was found both in male (265 ± 47 mg/dl vs 240 ± 44 mg/dl; p<0.01) and female offspring (277 ± 56 vs 260 ± 50 …mg/dl; p<0.05)). In addition, only the female offspring showed a higher leuiocyte count than the gcontrol group (7.03 ± 1.8 x 109 /l vs 6.51 ± 0.3 x 109 /l; p<0.05). No other hemorheological alterations were found. These results suggest that the offspring of people with essential hypertension (WHO I-II degree) show an increase in fibrinogen level as well as leucocyte count, which could constitute an indicator of the risk of developing arterial hypertension or its complications. Show more

Keywords: Hemorheology, hypertension, familiarity

DOI: 10.3233/CH-1996-16302

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 235-243, 1996

Authors: Battistelli, S. | Gori, S. | Righi, G.A. | Borgogni, T. | Manasse, G. | Guerrini, M.

Article Type: Research Article

Abstract: Endothelin is a potent endothelium-derived vasoconstrictor peptide. Its plasma levels fluctuate in relation to a variety of physiological and pathophysiological conditions. It has been reported that in hemiplegic patients blood pressure may be increased or decreased in the plegic ann according to the tone, spastic or flaccid, respectively, of the ann. To elucidate the pathophysiological significance of endothelin in hemiplegia blood pressure alterations, we measured the plasma endothelin levels of twelve elderly patients, both in the plegic and unaffected arm. Seven of them were affeted by spastic and five of them by flaccid hemiplegia, based on haemorrhagic or ischemic stroke. …Plasma endothelin concentrations were significantly higher (p<0.05) in the plegic arms (4.84 ± 1.66 pg/ml) than in the unaffected ones (4.48 ± 1.67 pg/ml) of patients independent of the spastic or flaccid tone. The increased level of plasma endothelin in the plegic arm suggests that endothelin does not take part in the hemiplegia blood pressure alterations. Endothelin could nevertheless be involved in the regulation of the vessel wall tension and may operate in blood volume homeostasis by mantaining the strict relationship between the venous wall and the intravascular volume. Show more

Keywords: Endothelin, Hemiplegia, Cerebrovascular disorders

DOI: 10.3233/CH-1996-16303

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 245-248, 1996

Authors: Hojjkes, Heinz-Gert | Dehn, Ralf | Saeger-Lorenz, Katrin | Franke, Astrid | Landgraf, Helmut | Ehrly, Albrecht M.

Article Type: Research Article

Abstract: It was the aim of the study to characterize the effects of normovolemic and hypervolemic hemodilution on the muscle pO2 in the tibialis anterior muscle of patients suffering from chronic arterial occlusive disease (stage IIb according to the Fontaine classification) with a pain-free walking distance below 100 m. To compare various Hct levels (ranging from 30% to 50%), normovolemic and hypervolemic hemodilution was performed either by subsequent withdrawal of whole blood and substitution with hydroxyethylstarch solution (200/0,5) or only by infusion of the same plasmaexpander. At rest, muscle pO2 readings obtained by a polarographic method (micro-pt-needle electrodes) indicated …clearly an impaired oxygen supply as compared to age-matched elderly volunteers. At the extreme ends of hematocrit in this study (Hct 33.75% and Hct 50.60%) muscle pO2 was significantly decreased as compared to Hct ranging from 38,57% to 45,38%. After a standardized pedal-ergometric exercise test a significant increase of muscle pO2 (2α<0,005) was found at Hct 40%–42%. Comparing normovolemic and hypervolemic hemodilution, hypervolemia at Hct 40%–42% did not improve muscle pO2 values after the pedalergometric exercise test. The data indicate, that normovolemic hemodilution towards the lower normal range (Hct 40% - 42%) can indeed improve muscle pO2 after pedalergometric exercise test in patients with severe intermittent claudication and concomitant increased Hct (Hct > 45%), whereas hypervolemic hemodilution showed no increase of muscle pO2 . Thus, normovolemic hemodilution should be the preferred hemodilution regimen in patients suffering from intermittent claudication. Show more

Keywords: Muscle tissue pO$_{2}$, Normovolemiclhemodilution, Hypervolemic hemodilution, Optimal hematocrit, Intermittent claudication

DOI: 10.3233/CH-1996-16304

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 249-265, 1996

Authors: Miao, Ge | Chuanmin, Zhang | Dapeng, Yue | Guoyong, Qiu

Article Type: Research Article

Abstract: In this paper, an analytical comparison is made between the normal values of 1372 determinations of whole blood viscosity (230s−1 ) from healthy female and five geographical factors in China's 23 areas. It is found that altitude is the main factor affecting the normal values of whole blood viscosity (230s−1 ). As altitude increases, the normal value of women whole blood viscosity also increases gradually. Applying the method of mathematical regression analysis, five formulas of univariate regression equations and a formula of multivariate regression equation are given. If geographical index values of altitude (X1 ), latitude (X2 ), relative humidity …(X3 ), annual average temperature(X4 ), annual precipitation (X5 ) in some place are known, the normal value of women whole blood viscosity (230s−1 ) in this area can be assessed according to the multivariate regression equation, Ŷ = 8.49 + 0.000424X1 - 0.0559X2 - 0.00684X3 + 0.0151X4 - 0.00116X5 ± 0.58. Show more

Keywords: Normal Value of Whole Blood Viscosity (230s$^{-1}$), Geographical Factors, Altitude, Regression Equation

DOI: 10.3233/CH-1996-16305

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 267-269, 1996

Authors: Erdinyler, D.S. | Karakoy, Y. | Toplan, S. | Onen, S. | Sukyasyan, A. | Beger, T. | Demiroğlu, Ç.

Article Type: Research Article

Abstract: In this study, we investigated the effect of ginkgoglycoside in two different doses (19.2 mg/day and 28.8 mg/day) on blood viscosity and erythrocyte deformability in 27 patients suffering from cerebrovascular insufficiency. The patients were divided into two groups randomly consisting of 13 and 14 patients respectively. Both groups received 28.8 mg/day ginkgoglycoside between the 1st and 15th day. The first group received the same dose until the end of the 30th day, whereas the dose administrated to the second group was reduced to 19.2 mg/day. In the first group, during 30 days a significant decrease in blood viscosity and a …significant increase in erythrocyte deformability were observed. In the second group on the other hand, after dose reduction, the effect of the drug on blood viscosity and erythrocyte deform ability were diminished. Improvement of symptoms including vertigo, tinnutus, headache and forgetfulness in the first group was found to be significantly different from the 2nd group at day 30 in a dose dependent manner. Show more

Keywords: Ginkgo Biloba glycoside, Blood viscosity, Erythrocyte deformability

DOI: 10.3233/CH-1996-16306

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 271-276, 1996

Authors: Mira, Yolanda | Vaya, Amparo | Martinez, Marcial | Solves, Pilar | Aznar, Justo

Article Type: Research Article

Abstract: We studied 25 patients with DVT in basal conditions and after 24 h of treatment with unfractionated heparin (UFH) to discover the possible effect of therapeutic doses of this drug on hemorheological parameters in these patients. The parameters studied are: erythrocyte aggregation (EA) at stasis (EA○ ) and a low shear rate (EA1 ), blood viscosity, plasma viscosity, fibrinogen and activated partial thromboplastin time. The results show that UFH significantly improves EA○ and EA1 , from 4.87 and 9.73 without heparin to 3.53 and 8.70 with heparin respectively. The other hemorheological characteristics are not significantly modified. We conclude that …UFH at therapeutic doses seems to improve erythrocyte aggregability regardless of the plasma level of fibrinogen. This suggests a possible direct effect of UFH on EA. Show more

Keywords: deep vein thrombosis, unfractionated heparin, hemorheology

DOI: 10.3233/CH-1996-16307

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 277-284, 1996

Authors: Kollegger, H. | Oberndorfer, S. | Oder, W. | Deecke, L.

Article Type: Research Article

Abstract: Viscoelastic parameters were measured in whole blQod of 19 multiple sclerosis patients (all of whom exhibited spastic paraparesis from chronic progressive disease course) and compared to age- and gender-matched control values of healthy subjects using an oscillatory capillary rheometer. At shear rates of 10 and 50 s−1 elasticity of multiple sclerosis patients was found to be significantly increased whereas filtration index, shear resistance and aggregation index of erythrocytes were equal in patients and control subjects. No differences were found when viscoelastic parameters of young (28–50 years) were compared to those of elderly (51–65 years) patients. Male patients showed …higher elasticity values at a shear rate of 10 s−1 than female patients. Severely impaired multiple sclerosis patients (EIS score 7–8) showed higher elasticity values at a shear rate of 50 s−1 than patients with less neurological impairment (EIS score 4–6). Our results indicate that elastic parameters are increased in whole blood of multiple sclerosis patients in comparison to controls, especially at low shear rates, even more so in male patients and in patients with severe neurological impairment. It is concluded that a subgroup of multiple sclerosis patients might be at risk for thromboembolic complications and might benefit from hemodilution therapy or the application of drugs inhibiting platelet aggregation. Show more

Keywords: whole blood viscoelasticity, multiple sclerosis

DOI: 10.3233/CH-1996-16308

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 285-290, 1996

Authors: Zong-yao, Wen | Tie, Gao | Weiyuan, Ma

Article Type: Research Article

Abstract: The effects of albumin on orientation and deformation for RBCs in a shear flow field of low viscosity have been studied with a new Ektacytometry proposed by ourselves. The results show that orientation index (DI)or for blood sample of albumin concentration <0.04g/L quickly increase with the albumin concentration and (DI)or , for blood sample of albumin concentration of 0.04g/L reach maximum value while (DI)or for blood sample of albumin concentration >0.5g/L intend to a stable value. From rheological point of view, abovementioned results were explained. Based on this, the optimum albumin concentration for studying nucrorheology of RBC was …selected. The results also show that (DI)or just depends on the deformability and the morphology ofRBC and it doesn't correlate with the lipid fluidity of RBC membrnae, and that the new Ektacytometry is better than traditional Ektacytometry in studying microrheology of RBC membrane. Show more

Keywords: Albumin, orientation of erythrocyte, shear flow field oflow viscosity

DOI: 10.3233/CH-1996-16309

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 291-301, 1996

Authors: Khodabandehlou, T. | Le Dévéhat, C. | Razavian, M.

Article Type: Research Article

Abstract: Two aspects regarding to the functional capacity of fibrinogen for aggregating the red cells were studied in both healthy volunteers and diabetic patients. The first one concerns the activation of the plasminogen that is present in the plasma, thereby involving the susceptibility of the plasma fibrinogen to degradation and ultimatly influencing the red cell aggregation characteristics. The second aspect concerns the quality of fibrinogen and its functional capacity for aggregating red cells. This later is carried-out on isolated and purified fibrinogen from plasma. Experiments made by activating the plasminogen suggest that fibrinogen is less degraded in the plasma of diabetic …patients. On the other hand, fibrinogen when isolated from plasma samples of diabetics, is found to be distinct from those obtained from healthy volunteers by its aggregative effects. Show more

Keywords: Fibrinogen, plasminogen activating, red cell aggregation, diabetes

DOI: 10.3233/CH-1996-16310

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 303-312, 1996

Authors: Demiroğlu, Halûk | Barişta, Ibrahim | Dündar, Semra

Article Type: Research Article

Abstract: Erythrocyte aggregation (EA) rates were measured at stasis (M) and at 3 sec−1 (M1) in four groups: healthy controls (HC) and three groups of coronary heart disease (CHD); stable angina pectoris (SAP), unstable angina pectoris (USAP) and post myocardial infarction (PostMI) patients. All CHD patients had similar risk factors. EA values were significantly higher. at M and M1 in USAP and PostMI groups than HC and SAP (p<0.0001). These values were also higher in men than women in premenopause (p<0.001) in HC group, but after menopause the differences were not significant (p>0.05). Since EA is higher in more severe …forms of CHD (USAP and PostMI) and atherosclerosis is more common in men than women before menopause, it is possible that EA might play a role in the development of especially severe forms of CHD. Show more

Keywords: Erythrocyte aggregation, coronary disease

DOI: 10.3233/CH-1996-16311

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 313-317, 1996

Authors: Ehrly, A.M.

Article Type: Research Article

DOI: 10.3233/CH-1996-16312

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 319-320, 1996

Authors: Höffkes, H.G. | Ehrly, A.M. | Franke, A. | Landgraf, H.

Article Type: Research Article

Abstract: Isovolumetric hemodilution (IHD) is an established therapeutic procedure to improve chronic ischemia in patients suffering from intermittend claudication of the lower limbs. It is, however, still subject of discussion at which hematocrit the relation between blood flow properties and oxygen carrying capacity of blood is at its optimum in this defmed ischemic disease. The aim of the present study was to characterize the influence of hematocrit variations on the muscle tissue oxygen supply as the defmed muscle tissue pO2 in these patients at rest and afte exercise. Design, Material, and Methods: IHD was performed twice within 14 days in 23 …patients (age: 41–72yrs) with a painfree walking distance less than 100 by withdrawl of whole blood and subsequent infusion of the same amount of a 10% hydroxyethyl starch solution 200/0.5 (HAES steril 10%, Fesenius, Oberusrsel Germany). Measurements of muscle tissue pO2 in the anterior tibial muscle (micro-needle-electrode method according to Ehrly and Schroeder) were performed regularly three days before and after pedalergometric exercise in parallel to several other hemodynamic and hemorheological tests. Results: At rest muscle tissue pO2 reading revealed an impaired oxygen supply at high (51 and low (34%) hematocrit values whereas an increase was found with hematocirt levels in ther normal range (approx. 40%). Mter excercise, significant increase of the muscle tissue pO2 was found exclusively at hematocrit levels of 40%–42%. This increase was accompanied by a “normalisation” of the execise induced pattern of “reactive hypoxia” as defmed by micro-needle-electrodes. Conclusion: In patients suffering from intermittent claudication IHD towards a hematocrit of 40%–42% resulted in improvement of muscle tissue oxygen supply and execise conditions. Further reduction of hematocritto hematocrit levels below 38% impairs muscle tissue oxygenation. Thus, for conservative treatment strategies, isovolemic hemodilution should be applied regularly and “optimal hematocrit” is the lower boderline of the normal range (40%–42%). Show more

Keywords: peripheral occlusive arterial disease, hemodilution treatment, hydroxyethylstarch, tissue oxygen tension

DOI: 10.3233/CH-1996-16313

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 321-327, 1996

Authors: Jung, E. | Erdlenbruch, W. | Koscielny, J. | Kiesewetter, H.

Article Type: Research Article

Abstract: In a Cross-Over study the influence of a hyper- and isovolaemic haemodilution on blood fluidity, blood flow in the macro- and microcirculation as well as on tissue oxygen tension (M. tibialis anterior) was investigated in n=8 patients with arterial occlusive disease stage II according to Fontaine. In both cases 500 ml hydroxyethyl starch (HES 20010.5 10%) were infused within a period of 60 minutes. In case of isovolaemic haemodilution 250 ml hydroxyethyl starch were given over 20 minutes, then 250 ml blood withdrawn (over 10 min), 250 ml hydroxyethyl starch given and at least again 250 ml blood withdrawn. …Prior to and 1, 3, 6 and 24 hours after haemodilution the rheological parameters (haematocrit, plasma viscosity, erythrocyte aggregation, erythrocyte rigidity and spontaneous thrombocyte aggregation) as well as the oxygen partial pressure histogram in the tibialis anterior muscle were measured. Blood pressure and heart rate did not change during and after haemodilution. Painfree walking distance increased after isovolaemic (105% after 1 h) more than after hypervolaemic (31% after 1 h) haemodilution. The fluidity of blood shows a significant improvement only after isovolaemic haemodilution; plasma viscosity decreased about 5%, erythrocyte aggregation about 22% and haematocrit about 16%. 24 h after haemodilution the rheological parameters reached initial values. The intramuscular oxygen partial pressure increased after hypervolaemic haemodilution about 35%, after isovolaemic haemodilution about 45%. Show more

Keywords: haemodilution, hydroxyethlyl starch, haemorheology, microcirculation

DOI: 10.3233/CH-1996-16314

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 329-342, 1996

Authors: Koscielny, J. | Jung, F. | Radtke, H. | Krause, S. | Moll, A. | Berg, R. | Schieffer, H. | Mrowietz, C. | Kiesewetter, H.

Article Type: Research Article

Abstract: The clinical benefit of hypervolumtric hemodilution combined with venesection applying 8 infusion of HES 200/0.5 10% (C2/C6 substitution ratio: 4.6) versus 8 Infusions of 250 ml Ringers' solution (p<0.05) was observed in this double blind placebo controlled crossover study on 20 patients (12 men, 8 women) of an average age of 58 with complaints of pectangina but free coronary system and/or symptoms of dyspnea and ischemia during stress ECGs or stress induced hypertension even at low stress levels. Only 2 patients presented mild side effects (hypertension, pectangina) without residual complaints. HES improved the microcirculation of the skin. HES increased blood …fluidity relevantly with particular influence on the plasma viscosity, the erythrocyte aggregation and hematocrit. Both infusion solutions decreased the systolic and diastolic blood pressure. The patients with pectangina profited clinically the most so that this form of treatment should be limited to this patient group. Show more

Keywords: Hypervolumetric hemodilution, myocardial microangiopathy, normal left-ventricular function and angiographicaUy free coronary system, clinical benefit only for patients with pectangina

DOI: 10.3233/CH-1996-16315

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 343-355, 1996

Authors: Wolf, Sebastian | Arend, Oliver | Bertram, Bernd | Knabben, Hildegard | Reim, Martin

Article Type: Research Article

Abstract: Systemic hemorheologic abnormalities may playa role in the pathogenesis of central retinal vein occlusions. A statistically significant elevation of plasma viscosity was found in patients with acute central retinal vein occlusion compared with control patients. Local retinal blood flow parameters including arteriovenous passage time and mean arterial dye bolus velocity were significantly altered in the central retinal vein occlusion patients versus age matched controls at baseline examination.We performed a randomized, prospective, single-blind clinical investigation to determine the effect of hemorheological manipulation on the clinical course and retinal blood flow of eyes with central vein occlusion. Hemodilution included plasma expansion with …hydroxyethyl-starch, withdrawal of whole blood if the hematocrit was above 42%, and rheologic manipulation with parenteral pentoxifylline. We found a statistically significant improvement in visual acuity at the last follow-up visit 36 months post-treatment for the treated group compared with the control group. The retinal blood flow parameters were markedly improved soon after the institution of therapy and may have contributed to the improved visual prognosis in the treated patient group. Show more

Keywords: hemodilution therapy, central retinalvein occlusion, retinal microcirculation

DOI: 10.3233/CH-1996-16316

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 357-365, 1996

Authors: Treib, Johannes | Haass, Anton | Grauer, Markus T. | Stoll, Martin | Koch, Dagmar | Schimrigk, Klaus

Article Type: Research Article

Abstract: Patients suffering from acute ischemic stroke have impaired cerebral autoregulation. For this reason, the perfusion of the penumbra depends directly on BP and CO. The CO can be increased by hypervolemic hemodilution and administration of positive inotropic drugs. In the present study, we examined the effect of different therapy protocols on hemodynamics in three patient groups. In patients with no manifest cardiac insufficiency, suffering from non-acute cerebrovascular diseases (group 1, n=6) we carried out a hypervolemic hemodilution with an initial loading dose. In a second group of patients (group 2, n=6), suffering from an acute stroke and limited cardiac …capacity, we combined hypervolemic hemodilution with administration of digitalis. In a third group of patients, suffering from an acute stroke, without manifest cardiac insufficiency, we combined hypervolemic hemodilution with the administration of sympathomimetics (group 3, n=6). Group 1 showed a rapid, 15% increase in CO that lasted approximately 3 hours. Group 2 showed a slow improvement in CO, which became apparent during the course of the therapy. Group 3 showed a rapid and lasting increase in CO of more than 30% which correlated closely with the administered dopamine/dobutamine dose. Hypervolemic hemodilution alone does not result in a rapid and long-lasting increase of CO, particularly not in patients with myocardial insufficiency. To improve the hemodynamic status of acute stroke patients, the administration of positive inotropic substances is a viable alternative. Show more

Keywords: blood pressure, cardiac output, hemodilution, hemodynamics, stroke Abbreviations: BP, blood pressure, CO, cardiac output, HES, hydroxyethyl starch, CCT, cranial computerised tomography

DOI: 10.3233/CH-1996-16317

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 367-375, 1996

Article Type: Abstract

DOI: 10.3233/CH-1996-16318

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 377-377, 1996

Article Type: Other

DOI: 10.3233/CH-1996-16319

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 379-380, 1996

Article Type: Other

DOI: 10.3233/CH-1996-16320

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 3, pp. 381-381, 1996