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Flow-dependent changes in microvascular permeability - an important adaptive phenomenon

F. E. Curry and G. F. Clough*

The exchange of solutes between the blood and tissue is increased by vasodilatation of arterioles to increase the number of vessels perfused, a reduction in diffusion distances in the tissue and the maintenance of concentration gradients across the walls of the exchange vessels. Most textbooks describe these as the primary mechanisms by which the metabolic demands of the tissues are met. However, in isolated skeletal and heart muscle preparations, in which all available exchange vessels are open and the surface area for exchange is close to maximum, the diffusion capacity for small solutes (measured as an effective permeability- surface area product, P_S) increases as the blood flow increases. The magnitude of the increase is 2- to 3-fold for solutes the size of glucose and sucrose, but may be larger for smaller solutes. The mechanisms determining these blood flow-dependent increases in diffusion capacity remain poorly understood (Renkin, 1984).

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