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Alterations of the microcirculation are common in critically ill patients and persistence of these alterations is associated with poor outcome. Infusion of high doses of activated protein C can ameliorate the microcirculation. Because red blood cells (RBCs) play an essential role in oxygen transport to the tissues, we studied the effects of activated protein C on RBC deformability in septic patients. RBC deformability, assessed by ektacytometry (LORCA system) for shear stresses between 0.30 and 50 Pa, was compared in healthy volunteers and in septic patients before and during activated protein C infusion. RBC deformability was altered in septic patients compared to healthy volunteers. RBC deformability improved transiently during activated protein C infusion for shear stresses of 4.89 and 7.78 Pa, but the elongation index increased by just 3.4 and 3.2%, respectively. RBC deformability was altered in sepsis. Activated protein C had no clinically relevant effects on RBC deformability as assessed using ektacytometry.


Michael Piagnerelli, Hassane Njimi, Tatiana Veloso Coelho, Giulia Reggiori, Diego Castanares Zapatero, Katia Donadello, Jean-Louis Vincent. Limited effects of activated protein C on red blood cell deformability. Clinical hemorheology and microcirculation. 2013;53(4):387-91

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PMID: 22504218

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