University of Cologne, Faculty of Medicine and University Hospital of Cologne, Department of Anaesthesiology and Intensive Care Medicine, Cologne, Germany.
University of Cologne, Faculty of Medicine and University Hospital of Cologne, Department of Dermatology, Cologne, Germany.
Blood Transfus. 2021 May;19(3):190-196. doi: 10.2450/2020.0025-20. Epub 2020 Jul 22.
The endothelium plays a pivotal role in regulating microvascular function, especially in situations associated with acute blood loss. Whether blood donation and the associated volume loss affects the dimensions of the endothelial surface layer (ESL) and glycocalyx integrity remains unknown.
This study was designed to determine real-time ESL and perfusion measurements of the sublingual microcirculation using sidestream dark field imaging performed in healthy subjects shortly before and after a donation of 500 mL whole blood. A novel image acquisition and analysis software (GlycoCheck™) automatically calculated the perfused boundary region (PBR), an inverse parameter for red blood cell (RBC) penetration into the ESL, in vessels between 5 and 25 μm in diameter. Microvascular perfusion was measured by RBC filling percentage. Soluble glycocalyx components were determined in the peripheral circulation.
There was no significant immediate effect of whole blood donation on PBR and RBC filling percentage. Linear regression analysis revealed a distinct association between change in PBR and change in RBC filling percentage (regression coefficient β: -0.040; 95% confidence interval: -0.049 to -0.030; p<0.001). A significant reduction in plasma heparan sulphate (1,329±316 vs 1,237±275 ng/mL, p=0.005) and hyaluronan (94±18 vs 90±16 ng/mL, p=0.002) was noted, while syndecan-1 levels (30 [23-50] vs 29 [24-46] ng/mL, p=0.282) remained unchanged.
Dimensions and integrity of the ESL appear to remain stable following a 500 mL whole blood donation and reflect its ability to ensure microvascular function and perfusion.
内皮细胞在调节微血管功能方面起着关键作用，特别是在与急性失血相关的情况下。献血和相关的容量损失是否会影响内皮表面层 (ESL) 的尺寸和糖萼完整性尚不清楚。
本研究旨在使用边流暗场成像 (sidestream dark field imaging) 确定健康受试者在捐献 500 毫升全血前后的舌下微循环的实时 ESL 和灌注测量值。一种新的图像采集和分析软件 (GlycoCheck™) 自动计算灌注边界区域 (PBR)，这是红细胞 (RBC) 穿透 ESL 的反参数，在 5 至 25μm 直径的血管中。微血管灌注通过 RBC 填充百分比测量。外周循环中测定可溶性糖萼成分。
全血捐献对 PBR 和 RBC 填充百分比没有立即的显著影响。线性回归分析显示 PBR 变化与 RBC 填充百分比变化之间存在明显的关联（回归系数β：-0.040；95%置信区间：-0.049 至-0.030；p<0.001）。发现血浆肝素硫酸盐 (1,329±316 对 1,237±275ng/mL，p=0.005) 和透明质酸 (94±18 对 90±16ng/mL，p=0.002) 显著降低，而 syndecan-1 水平 (30 [23-50] 对 29 [24-46]ng/mL，p=0.282) 保持不变。
在捐献 500 毫升全血后，ESL 的尺寸和完整性似乎保持稳定，这反映了其确保微血管功能和灌注的能力。
