Influence of the program for the accelerated recovery of postpartum women on the microviscosity of the erythrocyte membranes after cesarean section

Abstract

Background. This study aimed to analyze the microviscosity of membranes and the surface charge of erythrocytes and blood plasma proteins using fluorescent zones in pregnant women before and after cesarean section (CS) with traditional management of the perioperative period and use of an accelerated recovery program. Materials and methods. The study included pregnant women without somatic or obstetric complications. They were divided into groups that received traditional management during the perioperative period (fasting for 8 h before surgery and administration of an antibiotic after clamping the umbilical cord) and used an accelerated recovery program. The relative microviscosity of the erythrocyte membranes was assessed using the lateral diffusion method with a hydrophobic pyrene probe (C16H10). The surface charge of erythrocytes and blood plasma proteins was determined using the fluorescent probe 8-anilino-1-naphthalene sulfonic acid. Results. In postpartum women with an accelerated recovery program, the immersion of proteins in the lipid bilayer of the erythrocyte membrane decreased. The coefficient of pyrene eximerization in areas of protein–lipid contacts in the same group was higher and further increased both after anesthesia and after surgery. In the traditional management group, an increase in the eximerization coefficient was registered only after CS. In the areas of lipid–lipid contacts, the coefficient of pyrene eximerization in the accelerated recovery program group was significantly higher than that in the control group. Changes in the eximerization coefficient after anesthesia and surgery were insignificant. Moreover, the polarity of the microenvironment of both anular lipids and total lipids did not change. Conclusions. An increase in the pyrene eximerization coefficient in patients on an accelerated recovery program indicates a decrease in the microviscosity of erythrocyte membranes and an increase in their fluidity, which may be due to structural rearrangements of cell membranes and leads to an increase in their functional activity. The components of the accelerated recovery program affect the microviscosity of erythrocyte membranes, particularly in the areas of protein–lipid contacts, which may positively affect microcirculation in the perioperative period, which plays a significant role in the genesis of postoperative complications.