The relationship between hemorheological parameters and mortality in critically ill patients with and without sepsis

Totsimon, Kinga; Biró, Katalin T.; Szabo, Zsofia Eszter; Tóth, Kálmán; Kenyeres, Péter; Márton, Zsolt

doi:10.3233/ch-16136

Cited by 14 publications

(16 citation statements)

References 23 publications

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“…Plasma represents the suspending phase for blood cells and is considered a Newtonian fluid, thus alterations of its viscosity will lead to changes in whole blood viscosity independent of blood cells properties (changed or not) [3,6]. Plasma viscosity can be increased in acute phase of inflamatory diseases (increased mostly by plasma proteins, like fibrinogen and other acute phase reactants) and by extension, in sepsis [3,7].…”

Section: Blood Viscositymentioning

confidence: 99%

“…On the other hand, a low hematocrit (anemia) leads to kyperdynamic circulation [11]. In sepsis, development of a hyperviscosity syndrome is controversial and less probable [7]. Systemic inflamatory response syndrome (SIRS) is frequently associated with increased acute phase reactants which, in theory, leads to increased plasma viscosity [3], sepsis and septic shock associate seriously altered microcirculation (vasodialation) [1] and by extension, a hyperdinamic status, and also, in time, a progressive anemia [1,7,12] which, in turn, reduces blood viscosity [3,8].…”

Section: Blood Viscositymentioning

confidence: 99%

“…In sepsis, development of a hyperviscosity syndrome is controversial and less probable [7]. Systemic inflamatory response syndrome (SIRS) is frequently associated with increased acute phase reactants which, in theory, leads to increased plasma viscosity [3], sepsis and septic shock associate seriously altered microcirculation (vasodialation) [1] and by extension, a hyperdinamic status, and also, in time, a progressive anemia [1,7,12] which, in turn, reduces blood viscosity [3,8]. Blood viscosity in sepsis can maybe be characterized by an increased variability [7] caused first and foremost by the high volumes of fluids following aggressive volemic resuscitation [12].…”

Section: Blood Viscositymentioning

confidence: 99%

“…In sepsis, hematocrit value can be falsely increased with anemia [12], and this can modify studies results in blood rheology and also lead to false lower APACHE II scores in ICU patients assesment. Moreover, blood viscosity can be influenced by blood transfusions in sepsis [7]. Finally, knowing that dialysis increases blood viscosity and alters RBC rheology [15,16] patients who require renal replacement therapy may present further altered hemorheology.…”

Section: Blood Viscositymentioning

confidence: 99%

“…RBCs deformability can be an early marker of sepsis [7,25,26,27] and also a marker of severity [28]. Furthermore, altered deformability can be a prognostic factor being associated with outcome [29] and progression to organ dysfunction [30].…”

Section: Deformabilitymentioning

confidence: 99%

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Understanding Red Blood Cell Rheology in Sepsis and its Role in Clinical Practice. From Biomolecular Aspects to Possible Therapeutic Interventions

Moisa

Negoiță

Corneci

2018

Central European Journal of Clinical Research

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Erythrocyte rheology is of interest in understanding microcirculation and oxygen delivery and consumption alterations induced by sepsis and septic shock. Several mechanisms are proposed: (i) direct or indirect RBC membrane alterations, (ii) abnormal intraerythrocytic homeostasis, (iii) RBCs interaction with other cells and extracellular molecules, (iiii) increased reactive species production and altered redox homeostasis. In this review, we describe in part these mechanisms and what’s the impact of these hemorheological disturbances on the outcome and mortality rate. Also, we outline the possible therapeutic interventions and further perspectives regarding sepsis and septic shock management.

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Section: Blood Viscositymentioning

confidence: 99%

Section: Blood Viscositymentioning

confidence: 99%

Section: Blood Viscositymentioning

confidence: 99%

Section: Blood Viscositymentioning

confidence: 99%

Section: Deformabilitymentioning

confidence: 99%

See 3 more Smart Citations

Understanding Red Blood Cell Rheology in Sepsis and its Role in Clinical Practice. From Biomolecular Aspects to Possible Therapeutic Interventions

Moisa

Negoiță

Corneci

2018

Central European Journal of Clinical Research

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Increased blood viscosity and red blood cell aggregation in patients with COVID‐19

et al. 2021

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The aim of this study was to ( 1) analyze blood viscosity, red blood cell (RBC) deformability, and aggregation in hospitalized patients with Coronavirus disease 19 (COVID-19); (2) test the associations between impaired blood rheology and blood coagulation; and (3) test the associations between impaired blood rheology and several indicators of clinical severity. A total of 172 patients with COVID-19, hospitalized in COVID-unit of the Internal Medicine Department (Lyon, France) participated in this study between January and May 2021. Clinical parameters were collected for each patient. Routine hematological/biochemical parameters, blood viscosity, RBC deformability and aggregation, and RBC senescence markers were measured on the first day of hospitalization. A control group of 38 healthy individuals was constituted to compare the blood rheological and RBC profile. Rotational thromboelastography was performed in 76 patients to study clot formation dynamics. Our study demonstrated that patients with COVID-19 had increased blood viscosity despite lower hematocrit than healthy individuals, as well as increased RBC aggregation. In-vitro experiments demonstrated a strong contribution of plasma fibrinogen in this RBC hyper-aggregation. RBC aggregation correlated positively with clot firmness, negatively with clot formation time, and positively with the length of hospitalization. Patients with oxygen supplementation had higher RBC aggregation and blood viscosity than those without, and patients with pulmonary lesions had higher RBC aggregation and enhanced coagulation than those without. This study is the first to demonstrate blood hyper-viscosity and RBC hyper-aggregation in a large cohort of patients with COVID-19 and describe associations with enhanced coagulation and clinical outcomes. Elie Nader and Christophe Nougier contributed equally to this study. Yesim Dargaud and Philippe Connes contributed equally to this study.

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Effects of crystalloids and colloids on microcirculation, central venous oxygen saturation, and central venous-to-arterial carbon dioxide gap in a rabbit model of hemorrhagic shock

et al. 2018

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Objective The effects of hydroxyethyl starch (HES) on microcirculation, central venous oxygen saturation (ScvO 2 ), and the central venous-to-arterial carbon dioxide gap (dCO 2 ) are studied in a rabbit model of hemorrhagic shock for elucidating the advantages and drawbacks of resuscitation with HES compared with crystalloids. Methods An ear chamber and sublingual mucosa were used to examine blood vessels by intravital microscopy. Hemorrhagic shock was induced by removing nearly half of the blood volume. Twenty-two rabbits received 20 mL of HES by intravenous infusion immediately after bloodletting. Additional HES was then administered intravenously to a total volume of 100 mL. The other 22 rabbits (control) were intravenously given 40 mL of normal saline solution (NSS), followed by additional NSS to a total volume of 200 mL, administered under the same conditions as HES. Results After the infusion, the vessel density and perfusion rate of the sublingual microcirculation recovered in the HES group. The arteriolar diameter, blood flow velocity, and blood flow rate of the ear microcirculation were maintained in this group, and microcirculatory failure did not develop. In the NSS group, however, all 5 of the aforementioned measured variables were significantly smaller than those in the HES group after the completion of infusion. The recovery of ScvO 2 and dCO 2 to the respective baseline values was significantly better in the HES group than in the NSS group. Conclusion Intravenous infusion of HES effectively maintains adequate tissue oxygenation and perfusion in hemorrhagic shock.

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The relationship between hemorheological parameters and mortality in critically ill patients with and without sepsis

Cited by 14 publications

References 23 publications

Understanding Red Blood Cell Rheology in Sepsis and its Role in Clinical Practice. From Biomolecular Aspects to Possible Therapeutic Interventions

Understanding Red Blood Cell Rheology in Sepsis and its Role in Clinical Practice. From Biomolecular Aspects to Possible Therapeutic Interventions

Increased blood viscosity and red blood cell aggregation in patients with COVID‐19

Effects of crystalloids and colloids on microcirculation, central venous oxygen saturation, and central venous-to-arterial carbon dioxide gap in a rabbit model of hemorrhagic shock

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