Intravascular Hemolysis of Red Blood Cells in the Development of Organ Dysfunctions in Critical Conditions

• Main Author: Yu. I. Orlov
• Format: Article
• Language: Russian
• Published: Russian Academy of Medical Sciences 2008-04-01
• Series: Obŝaâ Reanimatologiâ
• Subjects: microcirculation; organ dysfunctions; red blood cell hemolysis; free hemoglobin; fe2+ ions; reperfusion.
• Online Access: https://www.reanimatology.com/rmt/article/view/797

The review analyzes the literature data, which suggest that microcirculatory bed disorders underlie organ dysfunctions in critical conditions, are largely associated with intravascular hemolysis of red blood cells, release of free hemoglobin and its subsequent catabolism to Fe2+ ions. Failure in the coagulation system, transport, and utilization of the trace element is assumed to develop during massive intravascular hemolysis. Excess Fe2+ ions that have a high catalytic activity may exert a direct damaging effect on the capillary endothelium with the development of capillary leakage. The large number of Fe2+ ions under hypoxia, acidosis, and reperfusion eliminate the major substrate for endogenous antioxidants — hydrogen peroxide, as well as superoxide radical, from the reactions of neutralization of primary active radicals, which is favorable to the activation of lipid peroxidation processes and the synthesis of more toxic secondary radicals.