Abstract
Red blood cell (RBC) aggregation induced by fibrinogen is a major determinant of the non-Newtonian flow behavior of blood and has been suggested as a possible contributing factor for disturbed microcirculatory flow and thrombogenesis. The purpose of the present investigation was to evaluate several experimental measures of RBC aggregation in order to determine their ability to differentiate between groups with low (25 neonates), normal (35 adult controls), and high (59 pregnant women, 24 nephrotic syndrome) fibrinogen levels. The following aggregation measures were employed: 1) Microscopic Aggregation Index (MAI); 2) Zeta Sedimentation Ratio (ZSR); 3) Aggregation Half Time (AHT) after cessation of shear; 4) Relative Light Transmission (RLT) after 1 and 10 minutes of stasis; 5) shear rate at Minimum Light Transmission (MLT); 5) Myrenne Erythrocyte Aggregation(MEA). All methods were able to distinguish aggregation between low and normal fibrinogen levels (p< 0.01) although the AHT, MLT and MEA present technical difficulties at low levels. At high fibrinogen levels, only the MAI method failed to show a difference from normal levels (p> 0.05). Only MAI and RLT were able to discriminate between subgroups at the low fibrinogen level and both MAI and MLT became insensitive to fibrinogen concentration at high levels. Thus, the use of only a single measure of RBC aggregation can be misleading, especially where it is desirable to detect differences between sub-groups of patients.
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Linderkamp, O., Hersch, S., Ozanne, P. et al. IN VITRO TECHNIQUES FOR THE ESTIMATION OF RBC AGGREGATION. Pediatr Res 19, 1133 (1985). https://doi.org/10.1203/00006450-198510000-00343
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DOI: https://doi.org/10.1203/00006450-198510000-00343