Influence of red blood cell aggregation on perfusion of an artificial microvascular network

Red blood cells (RBCs) suspended in plasma form multicellular aggregates under low flow conditions, increasing apparent blood viscosity at low shear rates. It has previously been unclear, however, if RBC aggregation affects microvascular perfusion. Here we analyzed the impact of RBC aggregation on perfusion and ‘capillary’ hematocrit in an artificial microvascular network (AMVN) at driving pressures ranging from 5 to 60 cmH2O to determine if aggregation could improve tissue oxygenation. RBCs were suspended at 30% hematocrit in either 46.5 g/L dextran 40 (D40, non-aggregating medium) or 35 g/L dextran 70 (D70, aggregating medium) solutions with equal viscosity. Aggregation was readily observed in the AMVN for RBCs suspended in D70 at driving pressures ? 40 cmH2O. The AMVN perfusion rate was the same for RBCs suspended in aggregating and non-aggregating medium, at both ‘venular’ and ‘capillary’ level. Estimated ‘capillary’ hematocrit was higher for D70 suspensions than for D40 suspensions at intermediate driving pressures (5 – 40 cm H2O). We conclude that although RBC aggregation did not affect the AMVN perfusion rate independently of the driving pressure, a higher hematocrit in the ‘capillaries’ of the network for D70 suspensions suggested a better oxygen transport capacity in the presence of RBC aggregation.