The effect of hematocrit and leukocyte adherence on flow direction in the microcirculation.

We sought to characterize how adherent leukocytes at the vessel wall, and the presence of erythrocytes, alter the streamlines (paths) of blood flow in the postcapillary venules. We directly visualized blood flow and leukocyte-endothelial cell interactions in postcapillary venules located in the cremaster muscle of anesthetized mice. Fluid streamlines were visualized by perfusing the cremaster muscle tissue with 0.5-micron fluorescent beads suspended in either buffer or whole blood, to examine the effect that erythrocytes have on the directionality of flow. Acute inflammation was induced in some animals by pretreatment of the vessels with tumor necrosis factor-alpha. To quantify the flow direction, the average deflection angle was defined as a scalar metric. Tracer bead trajectories were measurably altered by the presence of systemic levels of hematocrit, determined in each animal to be about 45%. Deviation from undirectional flow was also found to: (i) decrease with increasing vessel diameter, and (ii) increase with the number of adherent leukocytes. Fluid streamlines in the presence or absence of leukocyte adhesion or red cells agreed qualitatively with those obtained from theoretical calculations of blood flow using multiparticle adhesive dynamics. The microscale characteristics of venular flow are significantly altered during inflammation or changes in local hematocrit.