Mesenteric lymph duct ligation prevents shock-induced RBC deformability and shape changes

• Published in: The Journal of surgical research Vol. 109; no. 1; pp. 51 - 56
• Main Authors: Zaets, Sergey B, Berezina, Tamara L, Caruso, J, Xu, Da-Zhong, Deitch, Edwin A, Machiedo, George W
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 2003; Elsevier
• Subjects: Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthesia: equipment, devices; Animals; Biological and medical sciences; Cell Size; Erythrocyte Deformability; erythrocytes; Erythrocytes - pathology; Fundamental and applied biological sciences. Psychology; laser-assisted ektacytometry; Ligation; lymph; Lymphatic System - surgery; Male; Medical sciences; Mesentery; Microscopy, Electron, Scanning; Rats; Rats, Sprague-Dawley; scanning electron microscopy; Shock, Hemorrhagic - blood; trauma/hemorrhagic shock; Vertebrates: blood, hematopoietic organs, reticuloendothelial system; Wounds and Injuries; trauma/hemorrhagic shock; scanning electron microscopy; lymph; erythrocytes; laser-assisted ektacytometry; Shock; Biological properties; Scanning electron microscopy; Animal model; Deformability; Shape; Rat; Rodentia; Gut; Red blood cell; Cardiovascular disease; Case control study; Experimental study; Vertebrata; Mammalia; Animal; Cytometer; laser- assisted ektacytometry; Medical application; Elongation; Lymph
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/S0022-4804(02)00024-0

Objective. The exact mechanisms that lead to RBC deformability and shape changes after trauma/hemorrhagic shock remain unknown. We hypothesize that RBC injury is caused in part by gut injury and is mediated by gut-derived factors carried in the intestinal lymph. Materials and methods. RBC deformability was measured by a laser-assisted ektacytometer before and after trauma/hemorrhagic shock (T/HS) in 6 rats whose mesenteric lymph duct had been ligated and in 10 rats subjected to T/HS without duct ligation. In this assay a decrease in the elongation index is a marker of decreased RBC deformability. RBC shape was examined by scanning electron microscopy. Results. In the T/HS rats, the RBC elongation index decreased after T/HS from a preshock value of 0.064 ± 0.011 to 0.052 ± 0.009 ( P < 0.01) and remained low (0.049 ± 0.010) even at 3 h after resuscitation. In contrast, the elongation index did not decrease after T/HS in the lymph duct-ligated rats (0.062 ± 0.004 vs. 0.056 ± 0.005, P = NS). Likewise, the T/HS rats, but not the duct-ligated T/HS rats, had a significant increase in the percentage of abnormally shaped RBCs when studied by electron microscopy. Conclusions. Interruption of lymph flow from the gut into the bloodstream by lymph duct ligation prevents T/HS-induced RBC damage. Because decreased RBC deformability contributes to impaired perfusion of the microcirculation, preservation of RBC deformability may decrease the incidence of T/HS-induced organ dysfunction.