Blood flow and red blood cell deformation in nonuniform capillaries: Effects of the endothelial surface layer

Objective: A theoretical model is used to examine the mechanics of red blood cell (RBC) motion in nonuniform capillaries. The model includes effects of the endothelial surface layer (ESL), which is a layer of macromolecules adjacent to the endothelium and which impedes plasma flow. Methods: The motion of an BBC traversing a capillary with diameter varying sinusoidally between 5.4 mum and 7.4 mum is simulated numerically. The ESL is assumed to be 0.7-mum wide and deformable. Axisymmetric RBC shapes are assumed. Lubrication theory is used to analyze the motion of plasma around the RBC and through the ESL. Results: In a nonuniform capillary with no ESL. moving RBCs undergo large transient deformations and predicted flow resistance is substantially higher than in a uniform capillary with the same mean diameter. The presence of a deformable ESL reduces the transient fluid shear stresses and deformations experienced by RBCs traversing a nonuniform capillary. With an ESL. the increase in flow resistance resulting from nonuniformity is less than two fold versus three- to fourfold with no ESL in vessel geometries with the same ESL-free luminal region. Conclusions: The presence of the ESL reduces the impact of capillary irregularity on flow resistance and may protect RBCs traversing irregular capillaries from damage due to large., rapidly fluctuating external stresses.