Clinical Hemorheology and Microcirculation - Volume 39, issue 1-4

Authors: Velcheva, I. | Nikolova, G.

Article Type: Research Article

Abstract: The aim of the study was to follow the relationship of the hemorheological variables with the cognitive functions in patients with ischemic cerebrovascular disease (CVD). The patient material comprised 117 patients with CVD, distributed in two main groups: 44 with transient ischemic attacks (TIAs) and 73 with chronic cerebral infarctions (CCI), 48 of them being unilateral (UCI) and 25 bilateral (BCI). Additional relative distribution according to the mean arterial blood pressure (MABP) values or to the presence of pathological asymmetries of the hemispheric cerebral blood flow (CBF) was made. The main hemorheological variables: hematocrit (Ht), fibrinogen (Fib) and plasma viscosity …(PV) were examined. The cognitive functions were assessed with a psychological test battery for evaluation of the general cognitive state, the nonverbal intellect, the episodic memory, the selective attention and the executive functions. The hemorheological investigation revealed predomonant increase of PV. The results of all neuropsychological tests showed significant impairment in the patients with CCI in comparison to TIAs. Fibrinogen correlated best with the psychological parameters. Its increase was associated with disturbance of the nonverbal intellect and the general cognitive capacity in the patients with CCI and BCI. In the presence of lower MABP or lack of pathological asymmetries the correlations of Fib and PV with the psychological scores predominated. The results of our study reveal distinct association between the blood rheological properties and the cognitive functions in the patients with ischemic CVD, which is probably based not only on vascular but also on other nonvascular mechanisms. Show more

Keywords: Cerebrovascular disease, cognitive functions, hemorheological variables

DOI: 10.3233/CH-2008-1108

Citation: Clinical Hemorheology and Microcirculation, vol. 39, no. 1-4, pp. 397-402, 2008

Authors: Weinrich, Malte | Stephan, Bernhard | Weiss, Christel | Windischmann, Stefanie | Kopp, Berit | Pindur, Gerhard | Schilling, Martin K.

Article Type: Research Article

Abstract: Introduction: To reduce intraoperative blood loss in liver resections surgical bleeding control is often performed by a complete inflow obstruction of the liver called Pringle manoeuvre leading to a portal venous stasis. Platelet aggregability may be affected by this circulatory stasis. Materials and methods: A study population of 11 patients (37–67 years old, 7 females and 4 males) with hepatic tumours underwent elective liver resection. Pringle manoeuvre of up to 50 min duration was used in 4 patients. The other 7 patients were operated using selective vascular clamping. Platelets were aggregated before and after liver resection with adenosine diphosphate, …collagen and ristocetin (according to Born). Results: Mean maximal amplitudes of platelet aggregation were comparable before and after liver resection. Statistic analysis did not detect a significant difference between the values before and after liver resection as well as between Pringle manoeuvre and selective vascular clamping. Conclusion: Induced platelet aggregability is not affected by the method of surgical bleeding control used in liver resection. Platelet aggregability seems to be resistant even to portal venous stasis of up to 50 min during Pringle manoeuvre. Show more

Keywords: Induced platelet aggregation, Pringle manoeuvre, selective vascular clamping

DOI: 10.3233/CH-2008-1110

Citation: Clinical Hemorheology and Microcirculation, vol. 39, no. 1-4, pp. 403-408, 2008

Authors: Weinrich, Malte | Scheingraber, Stefan | Stephan, Bernhard | Weiss, Christel | Kayser, Anna | Kopp, Berit | Schilling, Martin K.

Article Type: Research Article

Abstract: Introduction: Measurement of central venous oxygen saturation has become a surrogate parameter for fluid administration, blood transfusions and treatment with catecholamines in (early) goal directed therapy in the treatment of acute septic patients. These strategies are not easily transferred to the postoperative management of abdominal surgery due to the different conditions in surgical patients. Materials and methods: A study population of 15 patients (8 females/7 males) underwent elective major abdominal surgery: 6 gastrectomies, 5 major liver resections and 4 lower anterior rectum resections. Surgery was performed for primary or secondary malignancy. The patients' age was 65.4±12.7 (mean±standard deviation, range …44–84, median 62) years. Blood samples were taken intraoperatively from indwelling central venous lines as well as from draining veins at the surgical site. Blood gas analyses to determine the oxygen saturations were performed immediately. All patients were operated in standardized general anesthesia including epidural analgesia and in a balanced volume status. Results: Central venous oxygen saturations and oxygen saturations in blood from the draining veins of the surgical site showed a wide range with high intra- and interindividual differences intraoperatively. Overall, at most time points no correlation between the two oxygen saturations could be detected in three operation types. A significant correlation was only observed at one time point during liver resections. Conclusion: Our results show a lack of correlation between central venous oxygen saturations and oxygen saturations in the draining veins of the surgical site during major abdominal surgery. Measurement of central venous oxygen saturations does not seem to be a good surrogate for the local oxygen supply in the field of interest in major abdominal surgery even under standardized conditions. Show more

Keywords: Central venous oxygen saturation, venous oxygen saturation at the surgical site, local venous oxygen saturation, major abdominal surgery

DOI: 10.3233/CH-2008-1111

Citation: Clinical Hemorheology and Microcirculation, vol. 39, no. 1-4, pp. 409-415, 2008

Authors: Wenzel, F. | Baertl, A. | Zimmermann, N. | Hohlfeld, Th. | Giers, G. | Oldenburg, J. | Assert, R.

Article Type: Research Article

Abstract: Introduction: Biomarkers reflecting an inflammatory or immunological response are increasingly offered to improve the risk stratification of patients. For example, current evidence suggests that soluble CD40 ligand (sCD40L) is elevated in patients with acute coronary syndrome. But only a few data are available to evaluate the influence of preanalytic conditions on sCD40L values. Methods: Blood samples of seven healthy blood donors were collected in tubes without additives and in EDTA- or citrate-filled tubes at various storage conditions. Platelet count was modified by serum dilution, and sCD40L was measured in platelet-rich-plasma and in whole blood. sCD40L levels were determined by …an commercially available ELISA-Kit. Results: Immediately after blood sample assessment, sCD40L levels in serum samples were elevated (1258±820 pg/ml) compared to EDTA (64±32 pg/ml) and citrate (60±8.5 pg/ml) values. Additionally, sCD40L levels were dependent on storage duration. After platelet activation, sCD40L levels were significantly increased to 8278±2453 pg/ml and were significantly correlated to platelet count (r=0.96). Conclusions: Soluble CD40L levels were clearly influenced by preanalytical conditions and were dependent on storage duration, sample technique and platelet count. These influences should be considered by the determination and evaluation of sCD40L concentrations. Show more

Keywords: Soluble CD40L, preanalytical conditions, platelet count, serum samples

DOI: 10.3233/CH-2008-1112

Citation: Clinical Hemorheology and Microcirculation, vol. 39, no. 1-4, pp. 417-422, 2008

Authors: Yerer, Mükerrem Betül | Aydoğan, Sami | Çomu, Faruk Metin

Article Type: Research Article

Abstract: Alterations in erythrocyte mechanical activities under the influence of anesthesia have been observed and discussed among the responsible factors for the deterioration of tissue and organ perfusion related to anesthetic procedures. 21 female and 17 male Swiss Albino rats were used. Female (f) and male (m) rats were divided into 3 groups; control (f (n=7); m (n=5)), sevoflurane treated group (f (n=7); m (n=5)), desflurane treated group (f (n=7); m (n=7)). 2% of sevoflurane or 6% desflurane were applied to the rats with inhalation in an adjustable cage for one hour. The deformability indexes of the erythrocytes were measured …by a laser diffractometer (Myrenne Rheodyne SSD). Sevoflurane anesthesia has improved the deformability of erythrocytes in male rats (p<0.05) whereas there were not any significant changes in female rats. Desflurane has improved the deformability of erythrocytes in both gender significantly (p<0.05). Volatil anesthetic agents sevofluran and desflurane has improved the mechanical properties of the erythrocytes in male rats compared to their controls. However, these changes were not significant with sevoflurane in females. The results in male rats may be due to the effects of testosterone on the flexibility of the erythrocytes leading them to tolerate to the environmental changes. These results reveal that the inhalation anesthetics like sevoflurane and desflurane are appropriate anesthetics which can improve the deformability of erythrocytes during surgery. Show more

Keywords: Sevoflurane, desflurane, anesthesia, erythrocyte deformability, rats

DOI: 10.3233/CH-2008-1113

Citation: Clinical Hemorheology and Microcirculation, vol. 39, no. 1-4, pp. 423-427, 2008

Article Type: Other

Citation: Clinical Hemorheology and Microcirculation, vol. 39, no. 1-4, pp. 429-435, 2008