A haemorheologiai vizsgálatok kísérletes sebészeti vonatkozásairól

Abstract

The hemorheological parameters, such as whole blood viscosity, plasma viscosity, hematocrit, fibrinogen concentration as well as the micro-rheological properties of red blood cells (red blood cell deformability and aggregation) play an important role in tissue perfusion. The alternating hemorheological parameters, which are also inter-related, have important effects in determining hemodynamical properties, as well. The altered hemorheological status has a direct effect on endothelial function by changing shear force profile on the endothelial wall, and impairment of red blood cell deformability and aggregation (presence of rigid red blood cell, and enhanced red blood cell aggregation) slows down microcirculation with disturbing capillary perfusion. In experimental surgery vascular clamping and release cause ischemia-reperfusion, which affect red blood cells in many ways: changes pH level, leads to free-radical release, changes osmolarity and lactate and NO concentrations as well as it causes mechanical trauma. Understanding of these pathophysiological processes and determining the extent of reversible-irreversible changes may help to delineate underlying causes in tissue perfusion and microcirculation better, and develop prophylactic and therapeutic possibilities. The challenges of experimental surgery also include the questions of comparability in different measurement methods, and understanding of interspecies-differences of experimental/laboratory animal models in order to increase the relevance of results in terms of applicability for the original, clinical question.