Impact of plasma viscosity on microcirculatory flow after traumatic haemorrhagic shock: a prospective observational study

David Naumann, Jon Hazeldine, Jon Bishop, Mark Midwinter, Paul Harrison, Gerard Nash, Sam D. Hutchings

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)
299 Downloads (Pure)

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 24h and 48h. 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 (p=0.040), higher (worse) MHI (p=0.033), and lower (worse) POEM scores (p=0.039).


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.
Original languageEnglish
JournalClinical hemorheology and microcirculation
Early online date19 May 2018
DOIs
Publication statusE-pub ahead of print - 19 May 2018

Keywords

  • visocsity
  • microcirculation
  • haemorrhage
  • trauma
  • fluids

Fingerprint

Dive into the research topics of 'Impact of plasma viscosity on microcirculatory flow after traumatic haemorrhagic shock: a prospective observational study'. Together they form a unique fingerprint.

Cite this