Blood Substitutes and the Intestinal Microcirculation: Extravasation and Ultrastructural Alterations
Three necessary requirements for hemoglobin (Hb)-based blood substitutes are (i) that they remain in the circulation for an appropriate time period, (ii) that they do not alter the mechanisms of macromolecular exchange between blood and tissue, and (iii) that they do not cause tissue damage. A problem with hemoglobin-based blood substitutes is that they may leave the circulation and produce cytotoxic side effects. One vital organ which is particularly adversely affected during hemorrhagic shock is the intestine. Shock results in loss of gut mucosal integrity, allowing translocation of bacteria and endotoxins into the circulation, resulting in a systemic inflammatory response. The intestine is also important with respect to the immune system because the mucosa contains Peyer’s patches, or organized aggregates of lymphoid tissue in between the villi. Peyer’s patches play a key role in the initiation and expression of mucosal immunity. For these reasons we decided to focus on the intestine with respect to its responses to blood substitutes.
KeywordsComplement Activation Oncotic Pressure Blood Substitute Hepes Buffer Saline Intestinal Microcirculation
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