Skip to main content
NCBI home page
Annals of Surgery logoLink to Annals of Surgery
. 1975 Dec;182(6):776–781. doi: 10.1097/00000658-197512000-00022

Effect of intravascular cellular aggregate dissolution in postoperative patients.

I Dawidson, J Barrett, E Miller, M S Litwin
PMCID: PMC1343979  PMID: 1190882

Abstract

It was the purpose of this study to confirm whether the increase in packed cell (PC) viscosity that occurs in humans after elective surgery is accompanied by a decrease in total body O2 consumption as previously noted in animals, and further to define the effect of resolution of intravascular cellular aggregates (ICA) on these parameters. Thirty nine patients were studied. Total body O2 consumption was 76% of normal 6 hours postop, 81% of normal 24 hours postop and 87% of normal 48 hours postop. Twenty four hours after operation PC viscosity and increased markedly. Saline infusion had no significant effect on total body O2 consumption or PC viscosity, either pre- or postop, but WB viscosity decreased linearly in proportion in the drop in hematocrit. Resolution of ICA by dextran-40 infusion was associated with return of total body O2 consumption and PC viscosity to normal; a decrease in WB viscosity was disproportionately greater than would have been seen had the decrease been due solely to the drop in hematocrit. It is concluded that in humans surgical trauma causes an increase in PC viscosity and microcirculatory impairment as evidenced by a decrease in total body O2 consumption. Resolution of ICA by dextran-40 infusion reverses that detrimental changes.

Full text

PDF
776

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BORGSTROM S., GELIN L. E., ZEDERFELDT B. The formation of vein thrombi following tissue injury: an experimental study in rabbits. Acta Chir Scand Suppl. 1959;Suppl 247:1–36. [PubMed] [Google Scholar]
  2. Carey J. S., Brown R. S., Woodward N. W., Yao S. T., Shoemaker W. C. Comparison of hemodynamic responses to whole blood and plasma expanders in clinical traumatic shock. Surg Gynecol Obstet. 1965 Nov;121(5):1059–1065. [PubMed] [Google Scholar]
  3. Chien S., Usami S., Dellenback R. J., Gregersen M. I., Nanninga L. B., Guest M. M. Blood viscosity: influence of erythrocyte aggregation. Science. 1967 Aug 18;157(3790):829–831. doi: 10.1126/science.157.3790.829. [DOI] [PubMed] [Google Scholar]
  4. Chien S., Usami S., Taylor H. M., Lundberg J. L., Gregersen M. I. Effects of hematocrit and plasma proteins on human blood rheology at low shear rates. J Appl Physiol. 1966 Jan;21(1):81–87. doi: 10.1152/jappl.1966.21.1.81. [DOI] [PubMed] [Google Scholar]
  5. Cohn J. N., Luria M. H. Studies in clinical shock and hypotension. 3. Comparative effects of vasopressor drugs and dextran. Arch Intern Med. 1965 Oct;116(4):562–566. [PubMed] [Google Scholar]
  6. DINTENFASS L. Considerations of the internal viscosity of red cells and its effect on the viscosity of whole blood. Angiology. 1962 Aug;13:333–344. doi: 10.1177/000331976201300801. [DOI] [PubMed] [Google Scholar]
  7. Dintenfass L., Burnard E. D. Effect of hydrogen ion concentration on the in-vitro viscosity of packed red cells and blood at high haematocritis. Med J Aust. 1966 Jun 18;1(25):1072–1074. doi: 10.5694/j.1326-5377.1966.tb73243.x. [DOI] [PubMed] [Google Scholar]
  8. GELIN L. E., INGELMAN B. Rheomacrodex--a new dextran solution for rheological treatment of impaired capillary flow. Acta Chir Scand. 1961 Nov;122:294–302. [PubMed] [Google Scholar]
  9. GOODWIN J. F. Estimation of plasma fibrinogen, using sodium sulfite fractionation. Am J Clin Pathol. 1961 Mar;35:227–232. doi: 10.1093/ajcp/35.3.227. [DOI] [PubMed] [Google Scholar]
  10. LITWIN M. S., BERGENTZ S. E., CARSTEN A., GELIN L. E., RUDENSTAM C. M., SOEDERHOLM B. HIDDEN ACIDOSIS FOLLOWING INTRAVASCULAR RED BLOOD CELL AGGREGATION IN DOGS: EFFECTS OF HIGH AND LOW VISCOSITY DEXTRAN. Ann Surg. 1965 Apr;161:532–538. doi: 10.1097/00000658-196504000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. LOFSTROM B. Intravascular aggregation and oxygen consumption: aggregation of red blood cells produced by high molecular weight dextran or by hypothermia. Acta Anaesthesiol Scand. 1959;3(1):41–51. doi: 10.1111/j.1399-6576.1959.tb00006.x. [DOI] [PubMed] [Google Scholar]
  12. Litwin M. S. Blood viscosity changes following surgical procedures. Surg Forum. 1968;19:51–52. [PubMed] [Google Scholar]
  13. Litwin M. S., Chapman K. Physical factors affecting human blood viscosity. J Surg Res. 1970 Sep;10(9):433–436. doi: 10.1016/0022-4804(70)90066-1. [DOI] [PubMed] [Google Scholar]
  14. Litwin M. S., Chapman K., Stoliar J. B. Blood viscosity in the normal man. Surgery. 1970 Feb;67(2):342–345. [PubMed] [Google Scholar]
  15. Litwin M. S. Comparison of effects of dextran 70 and dextran 40 in postoperative animals. Surgery. 1972 Feb;71(2):295–306. [PubMed] [Google Scholar]
  16. Litwin M. S., Relihan M. Effect of surgical operation on human blood viscosity. Surgery. 1973 Mar;73(3):323–328. [PubMed] [Google Scholar]
  17. MERRILL E. W., GILLILAND E. R., COKELET G., SHIN H., BRITTEN A., WELLS R. E., Jr Rheology of human blood, near and at zero flow. Effects of temperature and hematocrit level. Biophys J. 1963 May;3:199–213. doi: 10.1016/s0006-3495(63)86816-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Putnam T. C., Kevy S. V., Replogle R. L. Factors influencing the viscosity of blood. Surg Gynecol Obstet. 1967 Mar;124(3):547–552. [PubMed] [Google Scholar]
  19. RAND P. W., LACOMBE E. HEMODILUTION, TONICITY, AND BLOOD VISCOSITY. J Clin Invest. 1964 Nov;43:2214–2226. doi: 10.1172/JCI105095. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. REEMTSMA K., CREECH O., Jr Viscosity studies of blood, plasma, and plasma substitutes. J Thorac Cardiovasc Surg. 1962 Nov;44:674–680. [PubMed] [Google Scholar]
  21. ROBB H. J. THE ROLE OF MICRO-EMBOLISM IN THE PRODUCTION OF IRREVERSIBLE SHOCK. Ann Surg. 1963 Oct;158:685–697. doi: 10.1097/00000658-196310000-00015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. WELLS R. E., Jr, GAWRONSKI T. H., COX P. J., PERERA R. D. INFLUENCE OF FIBRINOGEN ON FLOW PROPERTIES OF ERYTHROCYTE SUSPENSIONS. Am J Physiol. 1964 Nov;207:1035–1040. doi: 10.1152/ajplegacy.1964.207.5.1035. [DOI] [PubMed] [Google Scholar]
  23. Wells R., Schmid-Schönbein H. Red cell deformation and fluidity of concentrated cell suspensions. J Appl Physiol. 1969 Aug;27(2):213–217. doi: 10.1152/jappl.1969.27.2.213. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES