Clinical Hemorheology and Microcirculation - Volume 4, issue 2-3
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Clinical Hemorheology and Microcirculation, a peer-reviewed international scientific journal, serves as an aid to understanding the flow properties of blood and the relationship to normal and abnormal physiology. The rapidly expanding science of hemorheology concerns blood, its components and the blood vessels with which blood interacts. It includes perihemorheology, i.e., the rheology of fluid and structures in the perivascular and interstitial spaces as well as the lymphatic system. The clinical aspects include pathogenesis, symptomatology and diagnostic methods, and the fields of prophylaxis and therapy in all branches of medicine and surgery, pharmacology and drug research.
The endeavour of the Editors-in-Chief and publishers of
Clinical Hemorheology and Microcirculation is to bring together contributions from those working in various fields related to blood flow all over the world. The editors of
Clinical Hemorheology and Microcirculation are from those countries in Europe, Asia, Australia and America where appreciable work in clinical hemorheology and microcirculation is being carried out. Each editor takes responsibility to decide on the acceptance of a manuscript. He is required to have the manuscript appraised by two referees and may be one of them himself. The executive editorial office, to which the manuscripts have been submitted, is responsible for rapid handling of the reviewing process.
Clinical Hemorheology and Microcirculation accepts original papers, brief communications, mini-reports and letters to the Editors-in-Chief. Review articles, providing general views and new insights into related subjects, are regularly invited by the Editors-in-Chief. Proceedings of international and national conferences on clinical hemorheology (in original form or as abstracts) complete the range of editorial features.
The following professionals and institutions will benefit most from subscribing to
Clinical Hemorheology and Microcirculation: medical practitioners in all fields including hematology, cardiology, geriatrics, angiology, surgery, obstetrics and gynecology, ophthalmology, otology, and neurology. Pharmacologists, clinical laboratories, blood transfusion centres, manufacturing firms producing diagnostic instruments, and the pharmaceutical industry will also benefit.
Important new topics will increasingly claim more pages of
Clinical Hemorheology and Microcirculation: the role of hemorheological and microcirculatory disturbances for epidemiology and prognosis, in particular regarding cardiovascular disorders, as well as its significance in the field of geriatrics. Authors and readers are invited to contact the editors for specific information or to make suggestions.
Abstract: The human red cell may be dangerous because of individual abnormalities or collectively because of a high concentration. The normal range of red cell concentration is probably not optimal and between 1% and 4% of the population are at a significantly increased risk of cardiovascular complications because of a high red cell concentration, albeit within the normal range. There is evidence that it may act as both a primary and a secondary risk factor. A number of mechanisms may mediate this pathological effect, including a direct effect on blood viscosity and bulk blood flow, an effect on platelet aggregation and…haemodynamic effects predisposing to thrombogenesis. The true optimal red cell concentration depends on larger number of variables than is usually accepted and may vary from individual to individual. The therapeutic value of normovolaemic haemodilution is discussed in this context.
Keywords: Red cell concentration, optimal haematocrit, cardiovascular risk factor, haemodilution
Abstract: The procedures of hypervolemic hemodilution (by infusion of colloidal solutions) and of isovolemic hemodilution (by exchange of colloidal solution against whole blood) have been shown to improve cerebral perfusion. In this review, the literature and the personal experience of the author in this field is evaluated. The concept of rheological improvement of cerebral perfusion was originally developped from the epidemiological observations which clearly identified high hemoglobin levels (or high hematocrit) as an important risk factor for cerebrovascular disease. These findings are in keeping with the extensive clinical experience that high hemoglobin concentration is associated with a reduction not only in…global cerebral perfusion, but also in cerebral red cell flux (flow multiplied by hematocrit). Conversely, anemia is associated with increased cerebral perfusion; there is no evidence that anemia is associated with neurological deficits. Various procedures to reduce hematocrit resulted in improved perfusion of cerebral and peripheral vascular beds in patients. These global results do not allow to draw firm conclusions about the mode of action: arguments for the action of whole blood and plasma viscosity, of the oxygen transport capacity or of vasodilator responses are reviewed. In closing, the clinical results of retrospective and of prospective studies of the principle of hemodilution, presently available, are summarized, as are adequate procedures for its application to patients.
Abstract: The effects of orally administered drugs on blood rheology and their clinical effects in peripheral and cerebral ischaemia are reviewed. Measurements of red cell deformability remains a major problem, and more sensitive and specific methodology is required for pharmacological studies. Stress tests of red cells are interesting models to investigate drug protection against cell rigidity, but which tests to choose is unclear. There is a lack of long-term, placebo-controlled, double-blind studies of the effects of conventional oral doses on blood rheology ex vivo in patients. Such studies might usefully be combined with future studies of clinical efficacy, which would…then allow correlation of rheological and clinical effects.