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Changes in the microcirculation system are most difficult to see and evaluate clinically, Roe E. Wells, MD, associate in medicine at Harvard Medical School, told the Hahnemann Medical College Symposium on Shock and Hypotension, March 18-21 in Philadelphia. Yet, such major therapeutic maneuvers as the infusion of large amounts of denatured blood elements in the treatment of shock may compromise blood flow within the microvasculature, Wells said. A poor flow environment in the microvasculature "may account for a continuing failure of capillary flow and tissue anoxia during the therapy of shock." Wells remarks were concerned with the threat to capillary flow from increased blood viscosity, cell aggregates, and also the effective blockading of nutrient capillaries and flocculation in the venules. Development of A-V shunts further hinders recognition of changes in this system, he said. "It is possible that with massive occlusion of arteriolar inflow or capillary injury a bypass response
Retarded Flow, Higher Fibrinogen, Globulin Levels Lead to Increased Blood Viscosity. JAMA. 1964;187(13):35-37. doi:10.1001/jama.1964.03060260083047