Abstract
As the hct rises above 60% in CCHD, there is an increased threat of thrombotic and hemorrhagic complications due to blood hyperviscosity. Hyperviscosity has been attributed to increased RBC mass. Since RBC deformability is a determinant of viscosity and flow at high hcts, we studied RBC deformability in 22 children with polycythemic CCHD and in 10 controls, using a Ciltration system. Filterability is a function of cell deformability. Washed RBC's resuspended in Ringer's lactate-albumin solution were passed through a 3u polycarbonate filter using hydrostatic pressure (at 25°C), and flow velocity was calculated (ul/sec).
Controls had a mean hct of 41%± 2, mean MCV of 87f1± 2, and mean RBC flow velocity of 5.0 ul/sec±.7. Children with CCHD were divided into 2 groups: 10 patients with hcts between 50-60% (mean 53±1), and 12 patients with hcts >60% (range 63-74%, mean 67%±1). Mean flow velocity (3.4ul/sec±2) in the group with hcts >60% was significantly (p=.05) reduced as compared to controls and the <60% hct group. The latter had a mean flow velocity of 4.8ul/sec±.7, which was comparable to controls. All groups were similar in age (mean 9.5 yrs), sex ratio and MCV.
We conclude that RBC's become stiffened when the hct exceeds 60% in CCHD. Stiffened RBC's may contribute to the thrombotic complications observed in these patients.
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Maurer, H., Mccue, C., Mcwilliams, N. et al. STIFFENED ERYTHROCYTES IN POLYCYTHEMIA OF CYANOTIC CONGENITAL HEART DISEASE (CCHD). Pediatr Res 11, 476 (1977). https://doi.org/10.1203/00006450-197704000-00637
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DOI: https://doi.org/10.1203/00006450-197704000-00637