Blood constituents

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Blood constituents. -Erythrocytes (red blood cells) -Leukocytes (white blood cells) -Thrombocytes (platelets) -Plasma (55-60% of volume): a). water (90-91%) b). proteins (6.5-8.5%) c). electrolytes, anions, etc. Determinants of blood viscosity. RBC concentration (hematocrit) - PowerPoint PPT Presentation

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  • Blood constituents-Erythrocytes (red blood cells)-Leukocytes (white blood cells)-Thrombocytes (platelets) -Plasma (55-60% of volume): a). water (90-91%) b). proteins (6.5-8.5%) c). electrolytes, anions, etc.

  • Determinants of blood viscosity RBC concentration (hematocrit)

    Plasma viscosity (Newtonian fluid)

    RBC deformability (at high hear rates)

    RBC aggregation (at low hear rates)

  • Normal (deformable) RBCsRoggenkamp, et al., 1986Dr. Max Hardeman, with permission

  • Pathologies related to significantly increased RBC aggregationCardiovascular diseasesDiabetesObesityHypertensionAtherosclerosisShock

  • Methods of evaluationBlood viscosity (viscometers; rheometers)RBC deformability (asymptotic blood viscosity; ektacytometry)RBC aggregation (low shear blood viscosity, erythrocyte sedimentation rate, aggregometers) Results obtained by the most of these methods strongly depend on hematocrit

  • Ratio of male to female mortality due to myocardial infarction, IHD, and cancer (Vital Statistics of the US)

  • HypothesesThe higher level of the circulating ovarian hormones (estrogens) that produce a vasodilatory effect mediated by NO on coronary arteries protect women of reproductive age (however, the increase in risk of heart disease was found to be essentially the same in women with surgically induced menopause regardless of ovary removal)Our hypothesis was that rheological properties of the premenopausal female blood are optimized by a monthly blood loss to maximize gas transport

  • Correlation between hematocrit and blood pressure Study of a large group of 17-18 years old teenagers (756 males and 705 females)

  • Number of teenagers with elevated blood pressure (above 140/85 mm Hg)MalesFemales

  • Number of teenagers with elevated hematocrit (Ht>50%) in the hypertensive groupsMalesFemales

  • Effect of hematocrit on blood viscosity20% difference in Ht causes ~90% and ~40% difference in low and high shear viscosity

    Chart1

    4894

    2248

    1326

    8.515.1

    69.4

    5.48.1

    5.17.6

    4.97.3

    4.46.3

    Ht=40%

    Ht=48%

    Shear rate (1/s)

    Viscosity (cP)

    Sheet1

    Shear RateHt=40%Ht=48%

    0.064894

    0.32248

    1.31326

    68.515.1

    3069.4

    605.48.1

    955.17.6

    1304.97.3

    5004.46.3

    Sheet1

    Ht=40%

    Ht=48%

    Shear rate (1/s)

    Viscosity (cP)

    Sheet2

    00

    00

    00

    00

    00

    00

    00

    00

    00

    Ht=40%

    Ht=48%

    Shear rate (1/s)

    Viscosity (cP)

    Sheet3

  • Fhraeus and Fhraeus-Lindquist effectsReduction of RBC concentration and apparent viscosity in microvessels (less than 0.5 mm diameter) due to development of the near-wall cell free layer and plasma skimming effect. The plasma layer increases the resistance for O2 diffusion and decreases vessel wall shear stresses.

  • RBC age distribution in male and female bloodMalesFemalesThe picture is based on data published by Micheli et al. , 1984

  • Whole bloodCentrifugedYoung RBCsOld RBCsRBCsPlasmaCentrifuged

  • RBCDeformabilityRBCSedimentationRateLow ShearViscosityRBCMechanicalFragilityp
  • Rheological parameters in male and premenopausal female blood

    PRIVATE

    Women

    n=47

    Men

    n=50

    Level of

    statistical

    significance

    Age, years

    25.74.8

    26.25.1

    n.s.

    Hematocrit, %

    40.02.4

    45.82.7

    p

  • Oxygen Delivery Index (hematocrit/blood viscosity )p
  • Chart1

    2.56

    2.757.0909090909

    3.057.868852459

    3.58.2857142857

    3.958.3544303797

    4.758.2105263158

    5.77.7192982456

    67.5833333333

    77.1428571429

    Viscosity

    ODI

    Hematocrit, %

    Viscosity, cP; ODI

    Oxygen Delivery Index vs.Viscosity

    Sheet1

    152.563.15

    19.52.757.09090909093.663.26

    243.057.8688524594.173.35

    293.58.2857142857

    333.958.35443037975.244.05

    394.758.21052631585.94.5

    445.77.71929824567.185.4

    45.567.58333333338.216.6

    5077.14285714298.2

    153.22

    203.36

    253.57

    303.9

    32.54.35

    35.54.9

    40.56.2

    457.5

    509.2

    151.748.62068965524.1848008035

    19.51.810.83333333335.2588996764

    241.9512.30769230775.9746079164

    29.52.312.82608695656.2262558041

    33.52.712.40740740746.0230133046

    39.53.5511.12676056345.4013400793

    44.54.45104.854368932

    1.93

    2.17

    2.62

    3.07

    3.97

    4.69

    Sheet1

    00

    00

    00

    00

    00

    00

    00

    00

    00

    Hematocrit, %

    ODI

    Oxygen Delivery Index (RBCs in plasma)

    Sheet2

    01

    00

    00

    00

    00

    00

    Hematocrit, %

    ODI

    Oxygen Delivery Index/plasma visc. (RBCs in PBS)

    Sheet3

    00

    00

    00

    00

    00

    00

    Hematocrit, %

    ODI

    Oxygen Delivery Index (RBCs in PBS)

    0

    0

    0

    0

    0

    0

    Blood viscosity vs. hematocrit (RBCs in PBS)

    00

    00

    00

    00

    00

    00

    y = 0.0037x2 - 0.1311x + 2.946

    0

    0

    0

    0

    0

    0

    0

    Blood viscosity vs. hematocrit (RBCs in plasma)

    y = 0.0068x2 - 0.276x + 6.2273

  • Asymptotic blood viscosity and oxygen delivery index (ODI) vs. hematocrit for pre-menopausal women (n=47) and age-matched men (n=50)

    Chart2

    5.37.6415094345.37.5471698113

    5.27.69230769235.67.1428571429

    5.27.69230769236.87.0588235294

    5.37.83018867926.97.1014492754

    5.17.84313725496.77.1641791045

    5.67.85714285716.77.2388059701

    5.27.88461538465.87.2413793103

    57.96.97.2463768116

    5.57.909090909167.3333333333

    5.17.941176470677.4285714286

    5.67.94642857145.77.4561403509

    5.157.96116504856.17.4590163934

    5.47.9629629636.37.4603174603

    5.18.03921568636.57.3076923077

    5.658.05309734516.27.5

    4.98.06122448986.27.5

    5.28.07692307696.47.5

    4.88.1256.87.5

    58.26.67.5757575758

    4.58.22222222226.27.5806451613

    4.98.265306122467.5833333333

    58.35.87.5862068966

    4.88.33333333336.37.619047619

    4.68.36956521745.97.6271186441

    4.78.40425531916.47.65625

    4.48.40909090915.67.6785714286

    5.18.4313725495.67.6785714286

    4.58.44444444445.47.6851851852

    4.38.4883720935.857.6923076923

    4.78.51063829795.77.7192982456

    4.758.52631578955.87.7586206897

    4.78.61702127665.47.7777777778

    4.78.61702127665.57.8181818182

    4.48.63636363645.37.8301886792

    4.68.69565217395.87.8448275862

    4.68.69565217395.357.8504672897

    4.558.79120879125.67.8571428571

    4.48.86363636365.97.8813559322

    4.58.88888888895.37.9245283019

    4.48.97727272735.87.9310344828

    4.49.09090909095.758

    49.1255.88.0172413793

    4.19.14634146345.38.0188679245

    4.29.16666666675.68.0357142857

    4.49.20454545455.78.0701754386

    3.99.23076923085.78.0701754386

    4.29.28571428575.28.0769230769

    3.89.47368421055.758.0869565217

    5.658.1415929204

    5.78.1578947368

    5.68.2142857143

    Viscosity (women)

    ODI (women)

    Viscosity (men)

    ODI (men)

    Hematocrit, %

    Blood viscosity (cP); ODI

    Sheet1

    HematocritAsym. visc.ODI

    40.55.37.641509434

    405.27.6923076923

    405.27.6923076923

    41.55.37.8301886792

    405.17.8431372549

    445.67.8571428571

    415.27.8846153846

    39.557.9

    43.55.57.9090909091

    40.55.17.9411764706

    44.55.67.9464285714

    415.157.9611650485AverageSt. dev

    435.47.962962963Ht40.01041666672.1049323619

    415.18.0392156863Visc.4.77916666670.4603228901

    45.55.658.0530973451ODI t-test, p=0

    39.54.98.061224489835

    425.28.07692307693649

    394.88.125374.48.4090909091

    4158.237.54.58.3333333333

    374.58.222222222237.54.48.5227272727

    40.54.98.265306122438.54.29.1666666667

    41.558.3394.88.125

    404.88.333333333339.54.68.5869565217

    38.54.68.369565217439.54.88.2291666667

    39.54.78.404255319139.54.78.4042553191

    374.48.409090909139.54.88.2291666667

    435.18.43137254939.54.88.2291666667

    384.58.44444444444058

    36.54.38.488372093404.49.0909090909

    404.78.5106382979405.47.4074074074

    40.54.758.5263157895404.78.5106382979

    40.54.78.6170212766

    40.54.78.6170212766404.88.3333333333

    384.48.6363636364405.27.6923076923

    404.68.6956521739404.58.8888888889

    404.68.6956521739404.68.6956521739

    404.558.791208791240.54.78.6170212766

    394.48.863636363640.54.98.2653061224

    404.58.888888888940.55.17.9411764706

    39.54.48.9772727273

    404.49.090909090940.54.78.6170212766

    36.549.12540.54.98.2653061224

    37.54.19.1463414634

    38.54.29.1666666667415.18.0392156863

    40.54.49.2045454545

    363.99.23076923084158.2

    394.29.2857142857

    363.89.473684210541.55.37.8301886792

    4258.4

    42.55.38.0188679245

    435.47.962962963

    445.48.1481481481

    MEN

    405.37.5471698113

    405.67.1428571429AverageSt. Deviation

    486.87.0588235294Ht45.552.7015679499

    496.97.1014492754Viscosity5.9490.4830272312

    486.77.1641791045

    48.56.77.2388059701

    425.87.2413793103

    506.97.2463768116

    4467.3333333333

    5277.4285714286

    42.55.77.4561403509

    45.56.17.4590163934

    476.37.4603174603

    47.56.57.3076923077

    46.56.27.5

    46.56.27.5

    486.47.5

    516.87.5

    506.67.5757575758

    476.27.5806451613

    45.567.5833333333

    445.87.5862068966

    486.37.619047619