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Serial Changes in Leukocyte Deformability and Whole Blood Rheology in Patients With Sepsis or Trauma

Nishino, Masato MD; Tanaka, Hiroshi MD; Ogura, Hiroshi MD; Inoue, Yoshiaki MD; Koh, Taichin BS; Fujita, Kieko BS; Sugimoto, Hisashi MD

Journal of Trauma-Injury Infection & Critical Care: December 2005 - Volume 59 - Issue 6 - pp 1425-1431
Article

Background: The objective of this study was to investigate serial changes in leukocyte deformability and rheologic properties of whole blood in patients with sepsis or trauma.

Methods: Seventeen sepsis patients and 22 trauma patients were enrolled. Leukocyte deformability and rheologic properties of whole blood were determined with the use of a microchannel array etched on a single-crystal silicon tip, simulating the microvasculature. The number of obstructed microchannels (NOM) was used as a measure of leukocyte deformability. Transit time (TT), i.e., the time taken for 100 μL of whole blood to pass through the microchannel array was also used as rheologic measure. Oxidative activity and F-actin content of neutrophils was measured in patients with sepsis.

Results: NOM and TT significantly increased in patients when sepsis was diagnosed. In survivors, NOM and TT decreased at the time of recovery from sepsis, but in non-survivors values remained high. Oxidative activity and F-actin content of neutrophils increased significantly as leukocyte deformability decreased. In patients with severe trauma, NOM and TT increased after injury and decreased by the time of recovery from the critical stage.

Conclusion: We conclude that leukocyte deformability decreases in patients with sepsis or severe trauma and that this change negatively affects rheologic properties of whole blood.

From the Department of Traumatology and Acute Critical Care Medicine (M.N., H.T., H.O., Y.I., K.F., H.S.), and the Department of Clinical Investigation (T.K.), Osaka University Medical School, Osaka, Japan.

Submitted for publication January 11, 2005.

Accepted for publication August 2, 2005.

Presented at the 59th Annual Meeting of the American Association for the Surgery of Trauma, September 16, 1999, Boston, MA.

Address for reprints: Hiroshi Tanaka, MD, Department of Traumatology and Acute Critical Care Medicine, Osaka University Medical School, 2-15 Yamadaoka, Suita-shi, Osaka 565-0871; email: tanaka@hp-emerg.med.osaka-u.ac.jp.

© 2005 Lippincott Williams & Wilkins, Inc.