The glycocalyx as a permeability barrier: basic science and clinical evidence

Critical Care

Perspective

Randal O. Dull¹  Robert G. Hahn² 

[1] Department of Anesthesiology, University of Arizona College of Medicine, Tucson, AZ, USA;Department of Pathology, University of Arizona College of Medicine, Tucson, AZ, USA;Department of Surgery, University of Arizona College of Medicine, Tucson, AZ, USA;Karolinska Institute at Danderyds Hospital (KIDS), Danderyd, Stockholm, Sweden;

关键词: Anesthesia;    Capillaries;    Glycocalyx;    Human studies;    Permeability;    Fluid kinetics;    Translational research;   

DOI  :  10.1186/s13054-022-04154-2

 received in 2022-05-30, accepted in 2022-08-15,  发布年份 2022

来源: Springer

【 摘 要 】

Preclinical studies in animals and human clinical trials question whether the endothelial glycocalyx layer is a clinically important permeability barrier. Glycocalyx breakdown products in plasma mostly originate from 99.6–99.8% of the endothelial surface not involved in transendothelial passage of water and proteins. Fragment concentrations correlate poorly with in vivo imaging of glycocalyx thickness, and calculations of expected glycocalyx resistance are incompatible with measured hydraulic conductivity values. Increases in plasma breakdown products in rats did not correlate with vascular permeability. Clinically, three studies in humans show inverse correlations between glycocalyx degradation products and the capillary leakage of albumin and fluid.

【 授权许可】

CC BY   
© The Author(s) 2022

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