BLOOD VISCOSITY IN SHOCK.
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Explore the source record for details and available documents.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
To investigate whether the increased glomerular filtration rate (GFR) in short-term diabetic patients is related to increased blood- or plasma viscosities, GFR [( 51Cr] EDTA-clearance), whole blood- and plasma viscosities were simultaneously determined in 16 insulin-dependent diabetic subjects, aged 11 to 34 years (duration of disease 0.1 to 8 years) and compared to the results in healthy subjects. Mean standard GFR +/- SD (that is, GFR corrected to body surface area of 1.73 m2) was significantly higher in the diabetics than in 16 age- and sex matched controls (142 +/- 26 ml/min vs. 123 +/- 18 ml/min, P less than 0.02). Blood viscosities at different shear rates and the plasma viscosity were not significantly different in the two groupes , although the plasma fibrinogen level was significantly elevated in the diabetics (376 +/- 60 mg%, vs. 289 +/- 37 mg%, P less than 0.001). No correlation was found between GFR and the viscosity measurements. The results of the present study do not support the suggestion that the increased GFR in short-term diabetics is related to changes in blood viscosity.
Sixty-two patients with intermittent claudication associated with peripheral arterial diseases were treated with clofibrate, 2 g daily, for a minimum of six months. Progress was compared with that in a similar pretreatment period and also with that of a matched untreated control group of 27 patients. The most striking effect of clofibrate was a steep and sustained fall in whole-blood viscosity measured over a wide range of shear rates. This was associated with a significant fall in abnormally raised initial plasma-fibrinogen levels. An increased proportion of patients on treatment showed evidence of clinical improvement. Clofibrate had no effect on the susceptibility of red blood cells to autoxidation but it led to a significant shift in the red cell fatty acid pattern.
The authors analyze their experience in the application of mexicor, a Russian cytoprotector, in 50patients with chronic coronary artery disease (CAD) and 51 patients with acute coronary syndrome. In additional to cytoprotective action, the use of mexidor in complex therapy of CAD lowers the functional activity of thrombocytes, eliminates high blood viscosity syndrome, and lowers low density lipoprotein cholesterol level. These favorable changes in hemorheological parameters improves myocardial perfusion, lowers the strength and frequency of coronary pain attacks, retards postinfarction left ventricular remodeling, and increases the quality of life of patients with various CAD forms.
First-pass radionuclide angiocardiography (FPRNA) with 99mTc-albumin was performed in 19 patients with cor pulmonale. Pulmonary circulation time (PCT), mean transit time (MTT), pulmonary stagnation index (PSI) were calculated from the time-activity curves for the estimation of cardiopulmonary circulation. Whole blood viscosity (WBV), plasma viscosity (PV) and hematocrit (HTC) were also measured on the same day. Significant prolongation of all parameters was observed (WBW: 5.04 +/- 1.19 mPas; PV: 1.36 +/- 0.17 mPas; HTC: 47.6 +/- 2.37%; PCT: 7.10 +/- 2.15 s; MTT: 9.33 +/- 4.11 s; PSI: 1.30 +/- 0.37) in patients with cor pulmonale. Significant positive correlations were found between PCT and WBV (r = 0.552; 0.001 < P < 0.01), MTT and WBV (r = 0.34; P < 0.05), furthermore between PCT and HTC (r = 0.356; P < 0.05). The results suggest that hemorheological parameters may influence the results of FPRNA, therefore, they should be determined in addition to the radionuclide study.
Eighteen patients with bone fractures and without systemic disease were studied for blood rheology. Blood and plasma viscosities, haematocrit, red cell aggregation and filterability as well as plasma colloid oncotic pressure were measured. Results show that patients exhibit a substantial haemorheological deficit on admission. During bedrest this returns to normal, owing to marked 'autohaemodilution'. It is concluded that trauma causes increased viscosity of blood in these patients. This change could predispose to deep vein thrombosis. However, such a risk is reduced by 'autohaemodilution' which is most probably an effect of immobilization.
AIM: To study acute haemorheological effects of intralipid in preterm and full-term neonates and children. Circulatory complications of intralipid infusion, such as increases in pulmonary and peripheral flow resistance, have been associated with impaired blood rheology. METHODS: During total parenteral nutrition, 10 preterm infants, 10 full-term neonates and 10 children received an initial dose of intralipid as continuous infusion (0.6 g/kg) over 4 h. Additionally, blood of 10 healthy preterm infants, 10 full-term neonates and 10 adults was incubated with intralipid. Whole blood and plasma viscosity (capillary viscometer), red blood cell (RBC) deformability (rheoscope) and RBC aggregation (Myrenne aggregometer) were measured before and after intralipid infusion and before and after in vitro incubation of blood with intralipid. RESULTS: During intralipid infusion, plasma triglyceride levels increased from 0.13 +/- 0.27 to 2.16 +/- 0.68 g/l in the preterm infants, from 0.14 +/- 0.21 to 1.64 +/- 0.54 g/l in the full-term neonates and from 0.65 +/- 0.31 to 2.26 +/- 0.60 g/l in the children. Whole blood viscosity decreased by about 10% after intralipid in all three groups due to similar decreases in haematocrit. RBC aggregation decreased by about 20% after intralipid infusion. Plasma proteins, plasma viscosity and RBC deformation were not affected by intralipid. In vitro incubation of blood with intralipid resulted in a marked reduction of RBC aggregation that was related to the intralipid concentration. At intralipid concentrations of 4 and 8 mg/ml, no RBC aggregation was noted in preterm and full-term neonates. In adults, RBC aggregation decreased by 50%. CONCLUSIONS: Previously described deleterious effects of intralipid on circulation can not be explained by changes in haemorheological properties.
Polyvalent intravenous immunoglobulin (IVIg) is considered to be standard therapy for a variety of autoimmune and idiopathic disorders. Several reports have emphasized the temporal association between administration of IVIg and thrombotic events. Recent experience with a patient who suffered a large myocardial infarction shortly after receiving IVIg led the authors to review the clinical and basic literature on administration of IVIg as a possible precipitant for myocardial infarction. Although the existence of an association between IVIg administration and myocardial ischemia has not been demonstrated in clinical trials, a body of clinical experience has begun to accumulate that is suggestive of an association between IVIg administration and cardiac and cerebral ischemia in older individuals or individuals with a known history of ischemic disease. Basic research demonstrating that IVIg administration may increase blood viscosity suggests that such an association is plausible.