The effect of cardiopulmonary bypass on the morphological characteristics of red blood cells and the gas transmission function of blood

Abstract

Investigate the effect of extracorporeal circulation on the erythrocyte morphology, the intensity of gas exchange in the body tissues of the patient was determined before the operation, during the operation and during the postoperative treatment using morphometric analysis of the form of erythrocytes. It was established that during the operation with artificial blood circulation, the ratio of the voltage of oxygen and carbon dioxide in arterial and venous blood changes, indicating a shift in the oxygen capacity of the blood. Since the oxygen concentration in the oxygenator is known and under constant control, a decrease in the oxygen capacity of the blood reflects the intensity of tissue respiration on the one hand, and the degree of mechanical damage to red blood cells on the other. The intensity of tissue respiration was judged on the basis of a previously unknown fact that the form of erythrocytes depends on the degree of their saturation with oxygen. It is noted that blood, saturated with oxygen (arterial) under normal conditions of gas exchange in the lungs, is 90-95% composed of small red blood cells (villous length 0,3-0,4 μm), venous blood is represented mainly by large vorous forms of red blood cells (villous length 0,4-1 μm). The form of red blood cells is reversible and changes both after passing through the lungs (oxygenator), and after gas exchange in the tissues. The inhibition of oxygen consumption by red blood during perfusion indicates a change in the metabolic processes, shape and resistance of red blood cells, which allows a more complete assessment of the pathophysiological changes that occur in the body in response to perfusion. The proposed methods of morphometric analysis of erythrocytes, as well as determining their osmotic resistance, can serve as express methods for analyzing red blood during heart operations using extracorporeal circulation, in order to correct it in time and replenish it.