Flow behavior of neonatal and adult erythrocytes in narrow capillaries

Abstract

This study was designed to analyze the flow behavior of red blood cells (RBCs) in circular vessels with diameters of 3 to 6 μm by means of a mathematical model. According to this model, the RBC flow velocity is 1 mm/sec, RBCs assume axisymmetric shape, and the gap between the RBC and the vessel wall allows sufficient lubrication. The flow resistance depends on the surface area and volume of RBCs, the plasma viscosity, and the vessel diameter. Surface area and volume of RBCs from 10 term neonates and 10 adults were determined by means of a micropipet system and plasma viscosity was measured using a capillary viscometer. Neonatal RBCs had larger volumes (107 ± 6 fl vs 90 ± 4 fl) and surface areas (154 ± 7 μm 2 vs 137 ± 7 μm 2) than adult RBCs ( P < 0.005). Plasma viscosity was lower in neonates than in adults (1.04 ± 0.10 cP vs 1.26 ± 0.13 cP; P < 0.005). The flow model leads to the following conclusions: During the passage of 3- to 6-μm vessels, the large neonatal RBCs are more elongated than the smaller adult RBCs. In vessels with diameters of less than 3.3 μm, the rear of neonatal RBCs becomes convex, whereas this critical vessel diameter is 3.1 μm for adult RBCs. If the cells are suspended in the same medium, neonatal RBCs require a 31% higher driving pressure than adult RBCs to achieve the necessary elongation for passing through a narrow capillary. However, both cell types require similar driving pressures, if the cells are suspended in the corresponding plasma. The tube/discharge hematocrit ratio of neonatal RBCs is 1 to 6% higher than that of adult cells. Relative viscosity of neonatal RBCs is approximately 7% higher compared with adult RBCs, whereas the blood viscosity (relative viscosity times plasma viscosity) is 12% less in neonates than in adults. We conclude that the large size of neonatal RBCs may cause impaired flow in narrow vessels with diameters below the critical value of 3.3 μm. In vessels with diameters of 3.3–6.0 μm, the disadvantage of the large size of neonatal RBCs appears to be completely compensated for by the lower plasma viscosity in the neonate.