Impact of plasma viscosity on microcirculatory flow after traumatic haemorrhagic shock: A prospective observational study.
Clin Hemorheol Microcirc
; 71(1): 71-82, 2019.
Article
de En
| MEDLINE
| ID: mdl-29843227
ABSTRACT
BACKGROUND:
Preclinical studies report that higher plasma viscosity improves microcirculatory flow after haemorrhagic shock and resuscitation, but no clinical study has tested this hypothesis.OBJECTIVE:
We investigated the relationship between plasma viscosity and sublingual microcirculatory flow in patients during resuscitation for traumatic haemorrhagic shock (THS).METHODS:
Sublingual video-microscopy was performed for 20 trauma patients with THS as soon as feasible in hospital, and then at 24âh and 48âh. Values were obtained for total vessel density, perfused vessel density, proportion of perfused vessels, microcirculatory flow index (MFI), microcirculatory heterogeneity index (MHI), and Point of Care Microcirculation (POEM) scores. Plasma viscosity was measured using a Wells-Brookfield cone and plate micro-viscometer. Logistic regression analyses examined relationships between microcirculatory parameters and plasma viscosity, adjusting for covariates (systolic blood pressure, heart rate, haematocrit, rate and volume of fluids, and rate of noradrenaline).RESULTS:
Higher plasma viscosity was not associated with improved microcirculatory parameters. Instead, there were weakly significant associations between higher plasma viscosity and lower (poorer) MFI (pâ=â0.040), higher (worse) MHI (pâ=â0.033), and lower (worse) POEM scores (pâ=â0.039).CONCLUSIONS:
The current study did not confirm the hypothesis that higher plasma viscosity improves microcirculatory flow dynamics in patients with THS. Further clinical investigations are warranted to determine whether viscosity is a physical parameter of importance during resuscitation of these patients.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Choc hémorragique
/
Microcirculation
Type d'étude:
Observational_studies
/
Risk_factors_studies
Limites:
Female
/
Humans
/
Male
Langue:
En
Journal:
Clin Hemorheol Microcirc
Sujet du journal:
ANGIOLOGIA
/
HEMATOLOGIA
Année:
2019
Type de document:
Article
Pays d'affiliation:
Royaume-Uni