Impaired Blood Rheology in Critically Ill Patients in an Intensive Care Unit

Critically ill patients are at increased risk of thromboembolic complications. Japanese patients admitted to the intensive care unit of Gunma University Hospital were divided into critically ill (high score) and moderately ill (low score) groups according to mean Acute Physiology and Chronic Health Evaluation (APACHE) II score. White blood cell count, potassium, creatinine, immunoglobulin G and blood passage time, measured using the microchannel method, were significantly higher and the platelet aggregation score and platelet count were significantly lower in the high-score group than in the low-score group, but other haemorheological parameters did not differ significantly between the two groups. White blood cell count, potassium, creatinine, APACHE II score and levels of immunoglobulins G, A and M were positively correlated with blood passage time in all patients. Critically ill patients had impaired blood rheology, which could result from increased white blood cell count, potassium, creatinine and immunoglobulins and may be associated with the pathophysiology of the thromboembolic process.

[1]  M. Kurabayashi,et al.  Conjugated estrogen plus medroxyprogesterone does not impair blood rheological properties in hypertensive postmenopausal women. , 2006, Maturitas.

[2]  T. Fuchs-Buder,et al.  Time course of procoagulant activity and D dimer in bronchoalveolar fluid of patients at risk for or with acute respiratory distress syndrome. , 1996, American journal of respiratory and critical care medicine.

[3]  G. Lowe.  Rheological influences on thrombosis. , 1994, Bailliere's best practice & research. Clinical haematology.

[4]  Masami Murakami,et al.  Relationships between blood rheology and age, body mass index, blood cell count, fibrinogen, and lipids in healthy subjects. , 2006, Clinical hemorheology and microcirculation.

[5]  J. Dormandy,et al.  High blood viscosity: An aetiological factor in venous thrombosis , 1973, The British journal of surgery.

[6]  J. Ricotta,et al.  Screening for asymptomatic deep vein thrombosis in surgical intensive care patients. , 1997, Journal of vascular surgery.

[7]  T. Pearson,et al.  Vascular occlusive episodes and venous haematocrit in primary proliferative polycythaemia. , 1978, Lancet.

[8]  Leukocytes and the risk of ischemic diseases. , 1987, JAMA.

[9]  T. Sudo,et al.  Characterization of whole blood aggregation with a new type of aggregometer by a screen filtration pressure method. , 2001, Thrombosis research.

[10]  G. Mchedlishvili,et al.  About spread of local cerebral hemorheological disorders to whole body in critical care patients. , 2004, Clinical hemorheology and microcirculation.

[11]  T. Pearson,et al.  VASCULAR OCCLUSIVE EPISODES AND VENOUS HÆMATOCRIT IN PRIMARY PROLIFERATIVE POLYCYTHÆMLX , 1978, The Lancet.

[12]  N. Agarwal,et al.  Acute pancreatitis: a multisystem disease. , 1993, The Gastroenterologist.

[13]  T Takahashi,et al.  Effect of Antihypertensive Therapy on Blood Rheology in Patients with Essential Hypertension , 2005, Journal of International Medical Research.

[14]  E. Ingenito,et al.  Prevalence of deep venous thrombosis among patients in medical intensive care. , 1996, JAMA.

[15]  E. Rackow,et al.  Influence of rheologic changes and platelet-neutrophil interactions on cell filtration in sepsis. , 2000, American journal of respiratory and critical care medicine.

[16]  Dries Dj.  Activation of the clotting system and complement after trauma , 1996 .

[17]  D. Dries.  Activation of the clotting system and complement after trauma. , 1996, New horizons.

[18]  J. Mayer,et al.  Thrombus und Embolus. Thrombose und Embolie , 1924 .

[19]  J. W. Henry,et al.  Untreated patients with pulmonary embolism. Outcome, clinical, and laboratory assessment. , 1995, Chest.

[20]  A. Ritter.  Thrombose und Embolie , 1955 .

[21]  S. Trottier,et al.  Femoral deep vein thrombosis associated with central venous catheterization: results from a prospective, randomized trial. , 1995, Critical care medicine.

[22]  K. Sato,et al.  Modified cell-flow microchannels in a single-crystal silicon substrate and flow behavior of blood cells. , 1994, Microvascular research.

[23]  Y Kikuchi,et al.  Effect of leukocytes and platelets on blood flow through a parallel array of microchannels: micro- and macroflow relation and rheological measures of leukocyte and platelet activities. , 1995, Microvascular research.

[24]  J. L. Gall,et al.  APACHE II--a severity of disease classification system. , 1986, Critical care medicine.

[25]  H. Ohki,et al.  Optically accessible microchannels formed in a single-crystal silicon substrate for studies of blood rheology. , 1992, Microvascular research.