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The impact of blood viscosity on health and disease has been neglected, even though viscosity is a fundamental property of any fluid. It is inversely proportional to flow, so increased blood viscosity predisposes to thrombosis. Blood viscosity is directly related to systemic vascular resistance, and so blood viscosity affects blood pressure. Blood viscosity is inversely proportional to perfusion, and increased viscosity adversely affects the performance of all organs. By viewing them through the perspective of viscosity, this book provides fresh insight into atherosclerotic cardiovascular disease, hypertension, metabolic syndrome, sepsis, hemolytic anemias, anemia of chronic disease, and aging.
The impact of blood viscosity on health and disease has been neglected, even though viscosity is a fundamental property of any fluid. It is inversely proportional to flow, so increased blood viscosity predisposes to thrombosis. Blood viscosity is directly related to systemic vascular resistance, and so blood viscosity affects blood pressure. Blood viscosity is inversely proportional to perfusion, and increased viscosity adversely affects the performance of all organs. By viewing them through the perspective of viscosity, this book provides fresh insight into atherosclerotic cardiovascular disease, hypertension, metabolic syndrome, sepsis, hemolytic anemias, anemia of chronic disease, and aging.
This e-book will review special features of the cerebral circulation and how they contribute to the physiology of the brain. It describes structural and functional properties of the cerebral circulation that are unique to the brain, an organ with high metabolic demands and the need for tight water and ion homeostasis. Autoregulation is pronounced in the brain, with myogenic, metabolic and neurogenic mechanisms contributing to maintain relatively constant blood flow during both increases and decreases in pressure. In addition, unlike peripheral organs where the majority of vascular resistance resides in small arteries and arterioles, large extracranial and intracranial arteries contribute significantly to vascular resistance in the brain. The prominent role of large arteries in cerebrovascular resistance helps maintain blood flow and protect downstream vessels during changes in perfusion pressure. The cerebral endothelium is also unique in that its barrier properties are in some way more like epithelium than endothelium in the periphery. The cerebral endothelium, known as the blood-brain barrier, has specialized tight junctions that do not allow ions to pass freely and has very low hydraulic conductivity and transcellular transport. This special configuration modifies Starling's forces in the brain microcirculation such that ions retained in the vascular lumen oppose water movement due to hydrostatic pressure. Tight water regulation is necessary in the brain because it has limited capacity for expansion within the skull. Increased intracranial pressure due to vasogenic edema can cause severe neurologic complications and death.
This presentation describes various aspects of the regulation of tissue oxygenation, including the roles of the circulatory system, respiratory system, and blood, the carrier of oxygen within these components of the cardiorespiratory system. The respiratory system takes oxygen from the atmosphere and transports it by diffusion from the air in the alveoli to the blood flowing through the pulmonary capillaries. The cardiovascular system then moves the oxygenated blood from the heart to the microcirculation of the various organs by convection, where oxygen is released from hemoglobin in the red blood cells and moves to the parenchymal cells of each tissue by diffusion. Oxygen that has diffused into cells is then utilized in the mitochondria to produce adenosine triphosphate (ATP), the energy currency of all cells. The mitochondria are able to produce ATP until the oxygen tension or PO2 on the cell surface falls to a critical level of about 4–5 mm Hg. Thus, in order to meet the energetic needs of cells, it is important to maintain a continuous supply of oxygen to the mitochondria at or above the critical PO2 . In order to accomplish this desired outcome, the cardiorespiratory system, including the blood, must be capable of regulation to ensure survival of all tissues under a wide range of circumstances. The purpose of this presentation is to provide basic information about the operation and regulation of the cardiovascular and respiratory systems, as well as the properties of the blood and parenchymal cells, so that a fundamental understanding of the regulation of tissue oxygenation is achieved.
The second edition of Transfusion Medicine and Hemostasis continues to be the only "pocket-size" quick reference for pathology residents and transfusion medicine fellows. It covers all topics in blood banking, transfusion medicine, and clinical and laboratory based coagulation. Short, focused chapters, organized by multiple hierarchical headings, are supplemented with up to 10 suggested reading citations. This single reference covers essentially all the topics required to meet the goals and objectives of a major program in transfusion medicine and clinical coagulation. New chapters in the coagulation testing section reflect the development of new tests available and their incorporation into clinical practice. Coverage includes essential updates on the importance of new cellular therapies, peripheral blood and bone marrow hematopoietic progenitor cells, as well as cord blood banking and regenerative medicine. The authors also examine advances in the understanding of molecular testing and pathogen reduction in two separate quality control chapters (one for blood centers and one for hospitals). - Updated content covers new coagulation tests, cellular therapies, and quality control issues - Easy to use, with focused, well-defined chapters in a standardized format throughout - Offers quick "cross-reference" lists at the end of each chapter - Includes lists of common abbreviations and indexes that cross reference diagnostic, clinical and therapeutic commonalities
The hemodynamic significance of the flow properties of blood was put into perspective only during the past decade. Advances in modern technologies today allow the quantitative analy sis of the fluidity of blood and its components under conditions approximating the flow in vivo, particularly those in the microcirculation. The hematocrit is the most important of the determinants of blood fluidity (reciprocal value of blood viscosity); acute increases in the hematocrit exert deleterious effects on circulation and oxygen transport owing to impaired fluidity of blood. High viscosity of plasma due to hyper- or dysproteinemias initiates the microcirculatory dysfunctions in hyperviscosity syndromes. Furthermore, the fluidity or deformability of red cells might be critically diminished and therefore cause redistribution of blood elements and adversely affect the resistance to flow within the microvessels. In low flow states blood fluidity most likely becomes the key determinant for microvessel perfu sion, overriding the neural and local metabolic control mechanisms operative at physiological conditions to adjust blood supply to tissue demand. Microcirculatory disturbances are there fore encountered whenever driving pressures are reduced, as in shock or hypotension, and distal to stenoses of macrovessels, but also in hemoconcentration due to plasma volume con traction, polycythemia, leukemia, and dysproteinemia. Based on experimental studies exploring the possibilities and limitations, with regard to improving the fluidity of blood by reducing the hematocrit, the concept of intentional hemo dilution has been introduced to clinical medicine.
After many years of relative neglect, the importance of study of factors governing blood flow has at last achieved recognition; in this volume are documented many of the techniques, and the basic scientific and clinical observations, which have helped to open up understanding of this highly important aspect of human physiology and pathology in recent years. The text is logically divided into five sections beginning with blood cell deformability, then moving on to theoretical consideration of blood rheology, followed by accounts of the interrelationships between rheology, blood flow and vascular occlusion. The final two sections deal with blood rheology in clinical practice and therapeutic aspects of the study of blood flow. As regards blood cell deformability (Section A), the basic problem is set out by Kiesewetter and colleagues in the first paragraph of chapter 1 (p. 3), in which they point out that whereas human erythrocytes at rest have a diameter of approxi mately 7. 5 /-tm, nutritive capillaries have diameters ranging from 3-5 /-tm, and chapters in section A give an account of the ways in which the red cell can undergo deformation to permit capillary perfusion and the maintenance of the microcirculation.
With the 13th edition, Wintrobe’s Clinical Hematology once again bridges the gap between the clinical practice of hematology and the basic foundations of science. Broken down into eight parts, this book provides readers with a comprehensive overview of: Laboratory Hematology, The Normal Hematologic System, Transfusion Medicine, Disorders of Red Cells, Hemostasis and Coagulation; Benign Disorders of Leukocytes, The Spleen and/or Immunoglobulins; Hematologic Malignancies, and Transplantation. Within these sections, there is a heavy focus on the morphological exam of the peripheral blood smear, bone marrow, lymph nodes, and other tissues. With the knowledge about gene therapy and immunotherapy expanding, new, up-to-date information about the process and application of these therapies is included. Likewise, the editors have completely revised material on stem cell transplantation in regards to both malignant and benign disorders, graft versus host disease, and the importance of long-term follow-up of transplantation survivors.