PHYSICAL EFFECTS IN RED BLOOD CELL TRAUMA

Red blood cell damage and destruction are important problems in the use of artificial valves, heart‐lung machines, and other devices which pump or process blood. An experimental study has been made on the mechanism of cell damage. Damage was defined by three types of observations on blood which had been subjected to trauma: (a) release of hemoglobin from cells (hemolysis), (b) morphological changes observed microscopically, and (c) red cell life span studies in rabbits using a Cr51 tagging technique. Three types of physical forces which might be injurious to red cells were studied; shearing stress (of known, constant magnitudes from a concentric cylinder viscometer), pressure variations (from studies in a static pressure cell), and direct impact of solid surfaces (from studies in a device which simulates the seating action of artificial heart valves). The study shows that high shearing stress may be primarily responsible for mechanical cell damage under certain important circumstances. There is a critical shearing stress above which cell damage increases markedly. Much of the cell damage does not appear as an immediate release of hemoglobin. Many cells undergo morphological changes and exhibit shortened average life span in vivo. The morphological changes due to shearing stress are very similar to the changes observed in patients who have hemolytic anemia associated with artificial valves. Copyright © 1969 American Institute of Chemical Engineers