scholarly journals Intraoperative changes in whole-blood viscosity in patients undergoing robot-assisted laparoscopic prostatectomy in the steep Trendelenburg position with pneumoperitoneum: a prospective nonrandomized observational cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jung-Woo Shim ◽  
Hyun Kyung Moon ◽  
Yong Hyun Park ◽  
Misun Park ◽  
Jaesik Park ◽  
...  
Keyword(s):  
Shear Rate ◽  
Supine Position ◽  
Blood Viscosity ◽  
Whole Blood ◽  
Hematocrit Level ◽  
Robot Assisted ◽  
Trendelenburg Position ◽  
Whole Blood Viscosity ◽  
Laparoscopic Prostatectomy ◽  
Steep Trendelenburg Position

Abstract Background The aim of this study was to investigate the effect of the steep Trendelenburg position (STP) with pneumoperitoneum on whole-blood viscosity (WBV) in patients undergoing robot-assisted laparoscopic prostatectomy (RALP). The study also analyzed the associations of clinical patient-specific and time-dependent variables with WBV and recorded postoperative outcomes. Methods Fifty-eight adult male patients (ASA physical status of I or II) undergoing elective RALP were prospectively analyzed in this study. WBV was intraoperatively measured three times: at the beginning of surgery in the supine position without pneumoperitoneum; after 30 min in the STP with pneumoperitoneum; and at the end of surgery in the supine position without pneumoperitoneum. The WBV at a high shear rate (300 s− 1) was recorded as systolic blood viscosity (SBV) and that at a low shear rate (5 s− 1) was recorded as diastolic blood viscosity (DBV). Systolic blood hyperviscosity was defined as > 13.0 cP at 300 s− 1 and diastolic blood hyperviscosity was defined as > 4.1 cP at 5 s− 1. Results The WBV and incidences of systolic and diastolic blood hyperviscosity significantly increased from the supine position without pneumoperitoneum to the STP with pneumoperitoneum. When RALP was performed in the STP with pneumoperitoneum, 12 patients (27.3%) who had normal SBV at the beginning of surgery and 11 patients (26.8%) who had normal DBV at the beginning of surgery developed new systolic and diastolic blood hyperviscosity, respectively. The degree of increase in WBV after positioning with the STP and pneumoperitoneum was higher in the patients with hyperviscosity than in those without hyperviscosity at the beginning of surgery. Higher preoperative body mass index (BMI) and hematocrit level were associated with the development of both systolic and diastolic blood hyperviscosity in the STP with pneumoperitoneum. All patients were postoperatively discharged without fatal complications. Conclusions Changes in surgical position may influence WBV, and higher preoperative BMI and hematocrit level are independent factors associated with the risk of hyperviscosity during RALP in the STP with pneumoperitoneum. Trial registration Clinical Research Information Service, Republic of Korea, approval number: KCT0003295 on October 25, 2018.

Whole blood viscosity in the evaluation of thrombogenic milieu in mitral stenosis

2021 ◽  
Vol 15 (3) ◽  
pp. 181-190
Author(s):  
Elif H Ozcan Cetin ◽  
Mehmet S Cetin ◽  
Mustafa B Ozbay ◽  
Hasan C Könte ◽  
Nezaket M Yaman ◽  
...  
Keyword(s):  
Shear Rate ◽  
Blood Viscosity ◽  
Whole Blood ◽  
Mitral Stenosis ◽  
High Shear Rate ◽  
High Shear ◽  
Whole Blood Viscosity ◽  
Spontaneous Echo Contrast ◽  
Shear Rates ◽  
Low Shear

Aim: We aimed to assess the association of whole blood with thromboembolic milieu in significant mitral stenosis patients. Methodology & results: We included 122 patients and classified patients into two groups as having thrombogenic milieu, thrombogenic milieu (+), otherwise patients without thrombogenic milieu, thrombogenic milieu (-). Whole blood viscosity (WBV) in both shear rates were higher in thrombogenic milieu (+) group comparing with thrombogenic milieu (-). WBV at high shear rate and WBV at low shear rate parameters were moderately correlated with grade of spontaneous echo contrast. Adjusted with other parameters, WBV parameters at both shear rates were associated with presence of thrombogenic milieu. Discussion & conclusion: We found that extrapolated WBV at both shear rates was significantly associated with the thrombogenic milieu in mitral stenosis. This easily available parameter may provide additional perspective about thrombogenic diathesis.

Blood Electrical Impedance Closely Matches Whole Blood Viscosity as Parameter of Hemorheology and Inflammation

2003 ◽  
Vol 13 (6) ◽  
pp. 305-312 ◽  
Author(s):  
G.A.M. Pop ◽  
W.J. Hop ◽  
L. Moraru ◽  
M. van der Jagt ◽  
J. Quak ◽  
...  
Keyword(s):  
Shear Rate ◽  
Blood Cell ◽  
Blood Viscosity ◽  
Whole Blood ◽  
Cell Aggregation ◽  
Whole Blood Viscosity ◽  
Red Blood Cell Aggregation ◽  
Exponential Increase ◽  
Blood Impedance ◽  
Low Shear

AbstractRed blood cell aggregation (RBCa) is a sensitive inflammation marker. RBCa determination from erythrocyte sedimentation rate, ESR, is used since long, but is unspecific unless corrected for hematocrit, Ht. Whole blood viscosity measurement at low shear rate is also sensitive to RBCa but is cumbersome to apply. To investigate whether electrical blood impedance, being sensitive to spatial red cell distribution, can be a good alternative to determine RBCa in low shear conditions. Blood was collected from 7 healthy volunteers. From each 16 different samples were prepared with 4 different Ht’s and with 4 different fibrinogen concentrations. Viscosity was measured at low shear rate (4.04 s-1) with a rotational viscometer at 37˚C. Electrical blood impedance was measured during similar shear conditions and temperature in a specially designed cuvette. ESR was determined according to Westergren. A logarithmic increase of viscosity as well as of capacitance, Cm, is seen when fibrinogen rises and an exponential increase when Ht rises. However, ESR shows a logarithmic decrease with increasing Ht and an exponential increase when fibrinogen rises. The viscosity could be accurately described using an exponential model. Under similar low shear conditions and temperature in-vitro, either whole blood viscosity or electrical blood capacitance reflect red blood cell aggregation due to fibrinogen and Ht variation in a similar way.

scholarly journals Analysis of the Blood Viscosity Behavior in the Sicilian Study on Juvenile Myocardial Infarction

2018 ◽  
Vol 24 (8) ◽  
pp. 1276-1281 ◽  
Author(s):  
Gregorio Caimi ◽  
Eugenia Hopps ◽  
Maria Montana ◽  
Giuseppe Andolina ◽  
Caterina Urso ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Shear Rate ◽  
Blood Viscosity ◽  
Whole Blood ◽  
Young Patients ◽  
Whole Blood Viscosity ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Initial Stage ◽  
Normal Controls

Considering the role of hemorheology in coronary circulation, we studied blood viscosity in patients with juvenile myocardial infarction. We examined whole blood viscosity at high shear rate using the cone-on-plate viscosimeter Wells-Brookfield ½ LVT and at low shear rate employing a viscometer Contraves LS30 in 120 patients (aged <46 years) with myocardial infarction, at the initial stage and subsequently 3 and 12 months after. At the initial stage, patients had an increased whole blood viscosity in comparison to normal controls. This hemorheological profile was not influenced by the cardiovascular risk factors, nor by the extent of coronary lesions, even if some differences were evident between patients with ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). The blood viscosity pattern at the initial stage did not influence recurring ischemic events or the onset of heart failure during an 18 months’ follow-up. The neutrophil to lymphocyte ratio did not affect the blood viscosity pattern. We reevaluated 83 patients 3 months after and 70 patients 12 months after the acute coronary syndrome, and we found that the hemorheological parameters were still altered in comparison to normal controls at both times. We observed an impairment of the hemorheological pattern in young patients with myocardial infarction, partially influenced by the infarction type (STEMI and NSTEMI) and persisting in the long term.

scholarly journals Incidence and Risk Factors of Pulmonary Complications after Robot-Assisted Laparoscopic Prostatectomy: A Retrospective Observational Analysis of 2208 Patients at a Large Single Center

2019 ◽  
Vol 8 (10) ◽  
pp. 1509 ◽  
Author(s):  
Yu ◽  
Park ◽  
Kim ◽  
Kim ◽  
Hwang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Body Mass ◽  
Pulmonary Complications ◽  
Invasive Technique ◽  
Single Center ◽  
Robot Assisted ◽  
Trendelenburg Position ◽  
Laparoscopic Prostatectomy ◽  
Steep Trendelenburg Position

Robot-assisted laparoscopic prostatectomy (RALP) is a minimally invasive technique for the treatment of prostate cancer. RALP requires the patient to be placed in the steep Trendelenburg position, along with pneumoperitoneum, which may increase the risk of postoperative pulmonary complications (PPCs). This large single-center retrospective study evaluated the incidence and risk factors of PPCs in 2208 patients who underwent RALP between 2014 and 2017. Patients were divided into those with (PPC group) and without (non-PPC group) PPCs. Postoperative outcomes were evaluated, and univariate and multivariate logistic regression analyses were performed to assess risk factors of PPCs. PPCs occurred in 682 patients (30.9%). Risk factors of PPCs included age (odds ratio [OR], 1.023; p = 0.001), body mass index (OR, 1.061; p = 0.001), hypoalbuminemia (OR, 1.653; p = 0.008), and positive end-expiratory pressure (PEEP) application (OR, 0.283; p < 0.001). The incidence of postoperative complications, rate of intensive care unit (ICU) admission, and duration of ICU stay were significantly greater in the PPC group than in the non-PPC group. In conclusion, the incidence of PPCs in patients who underwent RALP under pneumoperitoneum in the steep Trendelenburg position was 30.9%. Factors associated with PPCs included older age, higher body mass index, hypoalbuminemia, and lack of PEEP.

Influence of Postoperative Patient-Controlled Analgesia on Hemorheology in Patients Undergoing Hip Arthroplasty

2019 ◽  
Vol 158 (01) ◽  
pp. 41-45
Author(s):  
Yiping Bai ◽  
Liqun Mo ◽  
Liming Luan ◽  
Daiying Zhang
Keyword(s):  
Shear Rate ◽  
Hip Arthroplasty ◽  
Blood Viscosity ◽  
Whole Blood ◽  
Plasma Viscosity ◽  
Erythrocyte Aggregation ◽  
Control Group ◽  
Patient Controlled Analgesia ◽  
Noninvasive Blood Pressure ◽  
Whole Blood Viscosity

Abstract Objective To test the hypothesis that patient-controlled analgesia (PCA) contributes to improvement of hemorheology in patients undergoing hip arthroplasty. Methods 120 patients, aged 60 – 75 years old, undergoing hip arthroplasty under spinal anesthesia, were randomly divided into group PCA (n = 60) and control group (n = 60). Patients in PCA group received PCA in postoperative 3 days. Blood samples from the median cubital vein were collected at five time points: before anesthesia (T1), after surgery (T2), 6 h after surgery (T3), 24 h after surgery (T4), 48 h after surgery (T5). Hemorheological parameters were measured, including whole blood viscosity at a high shear rate (Hηb), whole blood viscosity at a low shear rate (Lηb), reduced viscosity (ηr), plasma viscosity (ηp), hematocrit (Hct), erythrocyte aggregation index(EAI) and erythrocyte deformation index (EDI). Noninvasive blood pressure and heart rate at T1-5 and pain scoring of visual analogue scale (VAS) score at T2-5 were recorded. Results (1) Compared with T1, Hηb, Lηb, ηp, ηr decreased significantly at T3–5 with EAI decreased significantly at T5 in group PCA (p < 0.05), EDI increased significantly at T5 in group C (p < 0.05). (2) Compared with group C, Hηb, Lηb, ηp, ηr, EAI decreased significantly at T5 with Lηb concurrently decreased at T4 in group PCA (p < 0.05). Conclusion Postoperative pain may increase blood viscosity in patients undergoing hip arthroplasty, mainly via plasma viscosity, erythrocyte aggregation and rigidity, and which could be improved by postoperative PCA.

scholarly journals The Contribution of Whole Blood Viscosity to the Process of Aortic Valve Sclerosis

2018 ◽  
Vol 27 (2) ◽  
pp. 173-178 ◽  
Author(s):  
Alper Sercelik ◽  
Abbas Fikret  Besnili
Keyword(s):  
Shear Rate ◽  
Aortic Valve ◽  
Roc Curve ◽  
Blood Viscosity ◽  
Whole Blood ◽  
Aortic Valve Sclerosis ◽  
Outflow Obstruction ◽  
Cutoff Value ◽  
Whole Blood Viscosity ◽  
Total Plasma Protein

Objective: We aimed to investigate whether increased whole blood viscosity (WBV) could be an important factor for the occurrence of aortic valve sclerosis (AVS). Subjects and Methods: A total of 209 patients were enrolled in the study. WBV was calculated using the hematocrit and total plasma protein at a low shear rate (LSR) and a high shear rate (HSR). AVS was defined as irregular valve thickening and calcification (without evidence of outflow obstruction) documented by a peak transvalvular velocity < 2.5 m/s on echocardiographic examination. The patient group consisted of 109 patients with AVS (77 females, 32 males), and 100 subjects without AVS (65 females, 35 males) were assigned to the control group. Results: In the AVS group, WBV values were significantly higher for HSR (17.4 ± 0.5 vs. 17.1 ± 0.7 208 s–1, p < 0.001) and LSR (65.9 ± 12.5 vs. 59.7 ± 16.7 0.5 s–1, p = 0.002). In multivariate logistic regression analysis, WBV at HSR and LSR were independent predictors of AVS (odds ratio, OR: 2.24, 95% confidence interval, CI: 1.38–3.64, p = 0.001; OR: 1.026, 95% CI: 1.006–1.046, p = 0.01, respectively). Receiver-operating characteristic (ROC) curve analysis indicated that a WBV cutoff value of 65.4 at LSR had a sensitivity of 46.8% and a specificity of 60.0% (area under the ROC curve, AUC: 0.615, 95% CI: 0.535–0.696, p = 0.004), and a WBV cutoff value of 17.1 at HSR had a sensitivity of 61.5% and specificity of 53% (AUC: 0.648, 95% CI: 0.571–0.725, p < 0.001) for the prediction of AVS. Conclusion: This study demonstrated that WBV was independently associated with AVS. WBV could be an indicator of inflammation and vessel remodeling without evidence of outflow obstruction.

Changes in Whole Blood Viscosity at Low Shear Rates Correlate with Intravascular Volume Changes during Hemodialysis

2012 ◽  
Vol 35 (6) ◽  
pp. 425-434 ◽  
Author(s):  
Won Kim ◽  
Sung Kwang Park ◽  
Kyung Pyo Kang ◽  
Dong Hwan Lee ◽  
Sam Yeon Kim ◽  
...  
Keyword(s):  
Shear Rate ◽  
Blood Volume ◽  
Blood Viscosity ◽  
Whole Blood ◽  
High Shear ◽  
Whole Blood Viscosity ◽  
Shear Rates ◽  
Before And After ◽  
The Relationship ◽  
Low Shear

Background: Elevated blood viscosity has been shown to be independently correlated with cardiovascular risk factors and associated with increased risk of major cardiovascular events, including death and acute myocardial infarction. The aim of the present study was to investigate changes in whole blood viscosity (WBV) at shear rates of 1, 5, and 300 s-1 before and after hemodialysis in patients with end-stage renal disease (ESRD). We also examined the relationship between the changes of WBV and intravascular blood volume. Methods: 43 patients with ESRD receiving maintenance hemodialysis were enrolled. WBV was measured using a scanning capillary tube viscometer pre- and post-dialysis to quantify dialytic viscosity surges. Body weight, blood pressure, and hematocrit were also measured before and after hemodialysis, as was the fluid removed during the session. Results: Hemodialysis had a 3 times greater impact on the low-shear WBV at a shear rate of 1 s-1 (i.e., 44.1% change) than on the high-shear WBV at a shear rate of 300 s-1 (i.e., 15.9% change). Changes in the low-shear WBV obtained at shear rates of 1 and 5 s-1 during hemodialysis were significantly correlated with changes in hematocrit. The intravascular blood volume reduction during hemodialysis was positively correlated with the changes in both high-shear and low-shear WBVs. Conclusions: These results suggest that the WBV parameter may hold additional information beyond hemoconcentration. Further research is needed to evaluate the relationship between low-shear WBV surges and increased morbidity in the patient population with ESRD.

Relationship between blood viscosity and no-reflow phenomenon in ST-segment elevation myocardial infarction performed in primary percutaneous coronary interventions

2021 ◽  
Author(s):  
Arafat Yildirim ◽  
Mehmet Kucukosmanoglu ◽  
Nermin Y Koyunsever ◽  
Yusuf Cekici ◽  
Mehmet C Belibagli ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Shear Rate ◽  
Blood Viscosity ◽  
Whole Blood ◽  
Odds Ratio ◽  
Multivariate Logistic Regression Analysis ◽  
Control Group ◽  
Whole Blood Viscosity ◽  
St Segment Elevation ◽  
No Reflow

Background: This study aimed to analyze the associations between no-reflow (NR) phenomenon development and whole-blood viscosity in patients with ST-elevated myocardial infarction. Methods: A total of 217 patients with ST-elevated myocardial infarction were included. whole-blood viscosity values were assessed using hematocrit and total protein values, and low shear rate (LSR) and high shear rate (HSR) were calculated. Results: The average LSR and HSR values of the study group were significantly higher than the control group (p < 0.001). Multivariate logistic regression analysis showed that both HSR (odds ratio: 4.957; p < 0.001) and LSR (odds ratio: 1.114; p < 0.001) were independent predictors for NR development. Conclusion: This study found that increased blood viscosity was an independent predictor for NR development.

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