Oxygen Delivery to Muscle Cells during Capillary Occlusion by Sickled Erythrocytes

LaCelle, Paul L.

doi:10.1007/978-3-642-67059-6_21

Cited by 12 publications

(10 citation statements)

References 9 publications

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“…One hypothesis, that deserves consideration, is that the shape of the dense discocyte might represent a bigger obstacle to capillary flow than the elongated ISC. Pertinent to this is the observation of La Celle (11) that deoxygenated ISC once in the capillary microcirculation of mice orient themselves along the vessel axis, posing no significant problem to the capillary flow. Hence, the ISC-induced obstruction occurs mainly at the junction of precapillary arterioles and true capillaries (11)(12)(13)(14).…”

Section: Hemodynamic Observationsmentioning

confidence: 93%

“…Pertinent to this is the observation of La Celle (11) that deoxygenated ISC once in the capillary microcirculation of mice orient themselves along the vessel axis, posing no significant problem to the capillary flow. Hence, the ISC-induced obstruction occurs mainly at the junction of precapillary arterioles and true capillaries (11)(12)(13)(14). We hypothesize that dense discocytes might, in fact, reach the capillaries more frequently (as they are less likely to be stopped in the junction point) but once deoxygenated would fail to deform appropriately for the requirements of flow, thus resulting in an effective capillary blockage.…”

Section: Hemodynamic Observationsmentioning

confidence: 93%

“…1) offers insight into the possible origin of the effects of fraction III cells on the microcirculation. It is well known that following deoxygenation most discoid cells (from fraction I and II) assume characteristic sickled shapes and that ISC (fraction IV) remain unchanged (11). Significantly, the dense discocytes of fraction III, like ISC, undergo minimal shape change on deoxygenation which suggests that they are converted to rigid diskshaped cells.…”

Section: Hemodynamic Observationsmentioning

confidence: 99%

See 2 more Smart Citations

Erythrocytes in sickle cell anemia are heterogeneous in their rheological and hemodynamic characteristics.

Kaul¹,

Fabry²,

Windisch³

et al. 1983

J. Clin. Invest.

216

155

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A B S T R A C T To understand the contribution to the pathophysiology of sickle cell anemia of the different erythrocyte density types present in the blood of these patients, we have studied the viscosimetric and hemodynamic characteristics of four major classes of hemoglobin SS erythrocytes. We have isolated reticulocytes, discocytes, dense discocytes, and irreversibly sickled cells (fractions I-IV) on Percoll-Renografin density gradients. Bulk viscosity was studied in a coneplate viscosimeter and the hemodynamic studies were performed on the isolated, artificially perfused mesoappendix vasculature of the rat (Baez preparation).Bulk viscosity measurements at shear rates of 230 s-' demonstrate that when the cells are oxygenated, fraction I (reticulocyte rich) has a higher viscosity than expected from its low intracellular hemoglobin concentration. The rest of the fractions exhibit moderate increases in bulk viscosity pari-passu with the corresponding increases in density (mean corpuscular hemoglobin concentration). When deoxygenated, all cell fractions nearly doubled their bulk viscosity and the deoxy-oxy differences remained constant. The Baez preparation renders a different picture: oxygenated fractions behave as predicted by the viscosimetric data, but, when deoxygenated, cell fractions exhibit dramatically increased peripheral resistance and the This work was presented, in part, at the 66th Annual

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Section: Hemodynamic Observationsmentioning

confidence: 93%

Section: Hemodynamic Observationsmentioning

confidence: 93%

Section: Hemodynamic Observationsmentioning

confidence: 99%

See 1 more Smart Citation

Erythrocytes in sickle cell anemia are heterogeneous in their rheological and hemodynamic characteristics.

Kaul¹,

Fabry²,

Windisch³

et al. 1983

J. Clin. Invest.

216

155

View full text Add to dashboard Cite

show abstract

“…For example, perfusion of the cremaster muscle (13,14), mesentery (15), or mesoappendix (16)(17)(18), while viewing these tissues through the microscope, has demonstrated the salient features of vaso-occlusion and red cell entrapment, as well as dramatic increases in resistance to flow within individual microvessels or in regional circulations during tissue deoxygenation. As fruitful as these experiments with "biological viscometers" (17) have been, their difficulties have generally precluded an assessment of the control and regulation of the microvasculature in the face ofthis blood Theological insult, particularly as it may pertain to the human subject.…”

Section: Introductionmentioning

confidence: 99%

Intravital microscopy of capillary hemodynamics in sickle cell disease.

Lipowsky¹,

Sheikh

Katz

1987

J. Clin. Invest.

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Crisis subjects exhibited a significantly depressed PORH with the ratio of peak red cell velocity to resting values reduced by 15% due to a loss of vasodilatory reserve, whereas crisis-free subjects exhibited a normal response. A 55% increase in the time to attain peak Vrbc was attributed to resistance increases, possibly resulting from red cell and leukocyte-to-endothelium adhesion during the induced ischemia.

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“…One patient developed posttransfusion hepatitis 2 weeks following ERCP, from which she subsequently recovered. A second patient developed deep venous thrombosis at the site of femoral vein catheterization 1 month following the procedure, which was Episodes of acute respiratory distress are a common cause of morbidity and mortality in SCD [28,29]. The constellation of findings, including fever, tachypnea, dyspnea and pulmonary infiltrates is now referred to as acute chest syndrome, in recognition of the difficulty in establishing a specific diagnosis for the respiratory dysfunction [30].…”

Section: Complicationsmentioning

confidence: 99%

Use of erythrocytapheresis in the treatment of patients with sickle cell anemia

Kleinman

Hurvitz

Goldfinger

1984

J of Clinical Apheresis

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We performed exchange transfusions, utilizing the technique of automated erythrocytapheresis, for the treatment of patients with sickle cell anemia. In an attempt to determine guidelines for the use of erythrocytapheresis, we studied the use of this procedure in three distinct clinical situations in nine patients with sickle cell disease. Patients with dangerous complications of sickle cell disease such as acute respiratory distress and priapism responded well to erythrocytapheresis, showing marked improvement within 24-48 hours. Patients with prolonged painful vasoocclusive crises showed only variable improvement after erythrocytapheresis therapy, insufficient to justify exposing the patient to the risks of the procedure. Patients treated to decrease the frequency of painful crises demonstrated no prolongation in symptom-free intervals between crises. Therefore, erythrocytapheresis has its main value in the management of acute, dangerous complications of sickle cell disease.

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Oxygen Delivery to Muscle Cells during Capillary Occlusion by Sickled Erythrocytes

Cited by 12 publications

References 9 publications

Erythrocytes in sickle cell anemia are heterogeneous in their rheological and hemodynamic characteristics.

Erythrocytes in sickle cell anemia are heterogeneous in their rheological and hemodynamic characteristics.

Intravital microscopy of capillary hemodynamics in sickle cell disease.

Use of erythrocytapheresis in the treatment of patients with sickle cell anemia

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