How Microcirculation Defines Patient Health
- January 31, 2023
With improved diagnostic tools, the role of microcirculation in overall health is becoming more defined. The microcirculatory system minimizes diffusion distance and covers the largest vascular surface area in the body. As the segment of the vascular system responsible for transporting leukocytes, red blood cells, proteins, and other blood components to and from tissue, the microcirculatory or microvascular system plays a central role in monitoring oxygen saturation and immune health.
Particularly in vascular beds dense with microvessels, such as the kidneys, heart, intestines, and brain, microcirculation can induce function failure or success; consequently, it can shed more light on the pathophysiology and treatment of conditions such as cardiovascular disease, hemorrhage, shock, and hypertension.
The importance of microcirculation is characterized by its primary receptor-mediated responsibilities and relationship to tissue-specific functions. This system has long-term, whole-body effects and is, therefore, a resource for promoting patient health and wellness. To enhance your patient care, consider the importance of microcirculation and the most beneficial ways to promote microcirculatory health.
As each vascular bed has vastly different needs, the microcirculatory system must be highly reactive to mediate several systems independently. The capillaries, venules, and arterioles transmit oxygen and necessary blood components to tissues according to cell-mediated signals. Arteriole, which brings blood from the arteries to the veins, use vascular smooth muscle cells to vary diameter and vascular tone in response to diverse stimuli.
Significantly, one function of microcirculation is lymphatic. The microvasculature is a pathway for inflammatory immune responses. Additionally, by communicating with cells like parenchymal cells, the microcirculatory system also plays a key role in tissue-specific functions.
Along with non-parenchymal cells (NPCs), parenchymal cells (PCs) are influential in tissue-specific functions. Tissue-resident microphages, components of NPCs, participate in crosstalk with PCs in the production of cytokines, inflammatory and anti-inflammatory signals, growth factors, and proteolytic enzymes. PCs are heavily involved in several physiological functions, including blood filtration, cardiac pulsation, and synaptogenesis.
Through its relationship to PCs, microcirculation defines tissue-specific inflammation and immune responses. Microcirculatory capillaries deliver red blood cells and the necessary oxygen to PCs. Failure to do so—through poor or dysfunctional microcirculation—can lead to health crises.
Microcirculation’s role in renal health has become a major focus for the treatment and management of renal health conditions such as chronic kidney disease. Peritubular capillaries, the microcirculatory vessels in the kidneys, are responsible for delivering waste to be disposed of by urine. In particular, recent studies have focused on the relationship between endothelial dysfunction and renal health.
Endothelial cells are responsible for moderating muscle tone and arteriolar blood flow. As the blood vessels of the microcirculatory system are almost invariably lined with endothelial cells, damaged endothelium may result in sustained vasoconstriction, which can dramatically impair renal function. Abnormalities and microcirculatory dysfunction has been correlated to renal fibrosis. This implicated the role of microcirculation in tissue maintenance and degeneration—and highlighted the importance of successful microcirculation for patient health.
Consequently, complications with microcirculation present a significant challenge to patients and physicians. As the terminal end of the vasculature, there is little that can be done for microcirculatory complications. Clots within the microcirculation cannot be bypassed, cleaned or stented, as the vessels are smaller than a hair. The most effective way to anticipate issues within the microcirculation is by testing fibrinogen levels. As a high-molecular-weight plasma adhesion protein, fibrinogen is a biomarker of inflammation that relates specifically to microcirculatory health. For those that are at higher risk of microcirculatory complications, consistent fibrinogen testing could be central to patient care. At risk patients include those with a history of smoking, diabetes, and high-stress. Males are also at a higher risk of renal microcirculation failure.
Microcirculatory Shock, Sepsis, and Organ Health
Partly due to the system’s relationship with renal health, microcirculation has recently become a point of interest for organ failure and shock in sepsis. According to a recent clinical study, irregular blood flow in capillaries, venules, and arterioles is related to the severity of organ failure and mortality in septic shock patients.
In the case of hemodynamic collapse, the microcirculatory system must regain tissue perfusion and correct the balance of red blood cells needed to restore oxygen to tissue cells. Therefore, in intensive care, hemodynamic resuscitation treatments for states of shock are designed to promote microcirculatory activity. Proper microcirculation, then, is connected to improved organ health and function.
Abnormalities that impair microcirculation and microcirculatory rarefaction correlate with cardiovascular disease (CVD). Microvascular dysfunction does not merely contribute to cardiovascular disease; it represents most of CVD. Coronary microvascular disease is more common than macrovascular disease.
Evaluating heart health through microcirculation function helps improve the treatment, management, and detection of cardiovascular disease, particularly for patients with comorbidities such as diabetes.
Microcirculatory flow, including determinations of vascular tone, the width of the vascular barrier, and other facets of microcirculation can be promoted by several health interventions.
The same lifestyle factors that influence heart health affect microcirculation. Balanced diets, regular exercise, and other health-conscious lifestyle choices can help improve microcirculation.
The endothelium has the ability to heal itself, but it can be strengthened with supplementation. According to a comprehensive review, supplements with vitamins C, D, and E could contribute positively to microcirculatory health.
Ischemia, venous incompetence, inflammation, and hypoxia can cause endothelial, glycocalyx, and red blood cell damage. This damage can spiral into adhesion and extravasation into the surrounding tissue, worsening inflammation and causing edemas.
Likewise, impairment of the nitric oxide system for vasodilation and vasorelaxation can hinder microcirculation, leading to tissue damage or death. Hypertension poses a significant threat to proper microcirculation. Hypertension causes microvascular walls to thicken, which constricts the flow of necessary blood components to myocardial tissue. As the increase of blood pressure signals greater peripheral resistance from the microcirculatory system, the resistance causes further elevation in blood pressure. This can lead to significant cardiac, brain, and kidney damages.
To promote microcirculatory health, it’s essential to focus on disease prevention, encourage patients to seek health lifestyles, and monitor your patients’ whole-body health. Access Medical Labs offers heart health and general wellness panels to improve your patient care. With next-day results and customizable profiles, Access Medical Labs is made to provide you and your patients with peace of mind. Explore our blood and saliva tests now.