Advertisement

Microrheological Aspects: Their Crucial Role in Multiple Organ Failure

  • Leopold Dintenfass

Abstract

Sequential breakdown in a number of crucial organs, such as the heart, kidneys, lungs, liver or brain, may take place over a span of seconds or many weeks. The crucial parameter in such a breakdown will be blood rheology, or more exactly, hyperviscosity of blood. Blood hyperviscosity can be due to elevation of anyone of the blood viscosity factors: elevation of plasma viscosity, elevation of packed cell volume (Haematocrit), elevation of the degree of aggregation of red cells (and especially the presence of large compact clumps of red cells), increase in the internal viscosity and rigidity of red cells, increase in the number and rigidity of the white cells, and presence of platelet aggregates. Blood hyperviscosity may be accompanied by an increase of the viscosity of whole blood, but it may be present in spite of normal or even decreased viscosity of whole blood when one of the viscosity factors is abnormally increased. The crucial role of blood hyperviscosity is especially apparent in the microcirculation. The effect of increased rigidity of blood cells or aggregates or clumps of blood cells, or the presence of microthrombi, microemboli or other products of blood coagulation is amplified by the “inversion phenomenon” in the microcapillary flow [1, 2].

Keywords

Shear Rate Multiple Organ Failure Blood Viscosity Relative Viscosity Platelet Aggregate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Dintenfass L (1971) Blood microrheology, viscosity factors in blood flow, ischaemia and thrombosis. Butterworths, LondonGoogle Scholar
  2. 2.
    Dintenfass L (1976) Rheology of blood in diagnostic and preventive medicine. Butterworths, LondonGoogle Scholar
  3. 3.
    Dintenfass L (1985) Blood viscosity, hyperviscosity and hyperviscosaemia. MTP Press and Kluwer, LancasterGoogle Scholar
  4. 4.
    Dintenfass L (1968) Internal viscosity of the red cell and a blood viscosity equation. Nature 219: 956–958PubMedCrossRefGoogle Scholar
  5. 5.
    Dintenfass L (1969) The internal viscosity of the red cell and the structure of the red cell membrane. Considerations of the liquid crystalline structure of the red cell interior and membrane from rheological data. Mol Cryst 8: 101–139CrossRefGoogle Scholar
  6. 6.
    Dintenfass L (1977) Theoretical aspects and clinical applications of the blood viscosity equation containing a term for the internal viscosity of the red cell. Blood Cells 3: 367–374Google Scholar
  7. 7.
    Knisely MH, Warner L, Harding F (1960) Ante-mortem settling. Microscopic observations and analyses of the settling of agglutinated blood-cell masses to the lower sides of vessels during life: a contribution to the biophysics of disease. Angiology 11: 535–550PubMedCrossRefGoogle Scholar
  8. 8.
    Talstad I (1971) The morphology of erythrocyte sedimentation rate (ESR). Acta Med Scand 190: 7–10PubMedCrossRefGoogle Scholar
  9. 9.
    Dintenfass L (1985) Red cell aggregation in cardiovascular diseases and crucial role of inversion phenomenon. Angiology 36: 315–326PubMedCrossRefGoogle Scholar
  10. 10.
    Dintenfass L, Jedrzejczyk H, Willard A (1982) Photographic, stereological and statistical methods in evaluation of aggregation of red cells in disease: I. Kinetics of aggregation. Biorheology 19: 567–577PubMedGoogle Scholar
  11. 11.
    Maseri A, L’Abbate A, Baroldi G (1978) Coronary artery spasm as a possible cause of myocardial infarction: a conclusion derived from study of preinfarction angina. N Engl J Med 299: 271–272CrossRefGoogle Scholar
  12. 12.
    Dintenfass L (1967) Dynamics of blood coagulation. Introducing a new coagulation factor “velocity gradient.” Haematologia 1: 387–400Google Scholar
  13. 13.
    Dintenfass L, Stewart JH (1968) Formation, consistency and degradation of artificial thrombi in severe renal failure. Effect of ABO blood groups. Thromb Diath Haemorrh 20: 267–284PubMedGoogle Scholar
  14. 14.
    Dintenfass L, Lake B (1977) Blood viscosity factors in evaluation of submaximal work output and cardiac activity in man. Angiology 28: 788–798PubMedCrossRefGoogle Scholar
  15. 15.
    Thompson K (1986) Not the James Mackenzie lecture-a concept of disease to educate the new type of doctor: discussion paper. J Roy Soc Med 79: 729–783PubMedGoogle Scholar
  16. 16.
    Dyer AR, Stamler J, Berkson DM, Lindbert HA, Stevens E (1975) High blood pressure: a risk factor for cancer mortality? Lancet 1: 1051–1056PubMedCrossRefGoogle Scholar
  17. 17.
    Dintenfass L, Zador I (1977) Hemorheology, chronic anxiety and psychosomatic pain: an apparent link. Lex et Scientia 13: 154–162Google Scholar
  18. 18.
    Bartrop RW, Luckhurst E, Lazarus L, Kiloh LG, Penny R (1977) Depressed lymphocyte function after bereavement. Lancet 1: 834–836PubMedCrossRefGoogle Scholar
  19. 19.
    Neuhof H (1982) Clinical problems in shock: microcirculation and peripheral gas exchange. Clinical Hemorheology 2: 691–703Google Scholar
  20. 20.
    Shoemaker WC (1979) Pathophysiology and therapy of shock states: use of hemodynamic and oxygen transport variables to predict survival and to guide therapy. In: The organ in shock. Upjohn, Kalamazoo, pp 75–87Google Scholar
  21. 21.
    Yedgar S, Eilam O, Shafrir E (1985) Regulation of plasma lipid levels by plasma viscosity in nephrotic rats. Am J Physiol 248: E10–E14PubMedGoogle Scholar
  22. 22.
    Yedgar, S, Weinstein DB, Patschi W, Schonfeld G, Casanada FE, Steinberg D (1982) Viscosity of culture medium as a regulator of synthesis and secretion of very low density lipoproteins by cultural hepatocytes. J Biol Chem 257: 2188–2192PubMedGoogle Scholar
  23. 23.
    Hovav E, Halle C, Yedgar S (1987) Viscous macromolecules inhibit erythrocyte hemolysis induced by snake venom phospholipase A2. Biorheology (in press)Google Scholar
  24. 24.
    Kuhn W (1960) Prinzip der Erzeugung mechanischer Energie durch makromolekulare Systeme. Makromolek Chemie 35: 200–220CrossRefGoogle Scholar
  25. 25.
    Dintenfass L (1976) Malfunction of viscosity-receptors (viscoreceptors) as the cause of hypertension. Am Heart J 92: 260–263PubMedCrossRefGoogle Scholar
  26. 26.
    Dintenfass L (1977) Hypothesis of viscoreceptors: malfunction of viscoreceptors and viscosity-controllers in hypertension and polycythaemia. Bibliot Anat 16: 478–480 (9th European Conference on Microcirculation, Antwerp 1976)Google Scholar
  27. 27.
    Dintenfass L (1980) Autoregulation of blood viscosity in health and disease. Vascular Surgery 14: 227–237Google Scholar
  28. 28.
    Dintenfass L (1981) Hyperviscosity in hypertension. Pergamon, SydneyGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 1988

Authors and Affiliations

  • Leopold Dintenfass
    • 1
    • 2
  1. 1.Department of MedicineUniversity of SydneyAustralia
  2. 2.Clinical Haemorheology DepartmentRachel Forster HospitalRedfernAustralia

Personalised recommendations