Abstract
As reduced red cell deformability (RCD) can contribute to derangement of the microcirculation, a central feature in the pathogenesis of severe malaria, RCD was measured with a laser diffraction technique in 232 consecutive patients with falciparum malaria on the Kenyan coast, of whom 99 had severe disease. RCD on admission (measured as elongation index [EI] at shear stress = 1·7 Pa) was reduced in proportion with severity of disease (fatal outcome: EI = 0·182 (SD = 0·048), survivors from severe disease: El = 0·217 (SD = 0·043), uncomplicated malaria: EI = 0·249 (SD = 0·030), healthy controls: EI = 0·268 (SD = 0·022)). All but 2 survivors with severe malaria and rigid erythrocytes received a blood transfusion restoring RCD. Reduced RCD may contribute to impaired microcirculatory flow and a fatal outcome in falciparum malaria. RCD can be improved by blood transfusion. Since severely reduced RCD has a strong predictive value for mortality, blood transfusion possibly improves disease outcome not only through its beneficial effect on anaemia but also on RCD.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have