The endothelial glycocalyx: a review of the vascular barrier
Abstract
Summary: The endothelial glycocalyx is an important part of the vascular barrier. The glycocalyx is intimately linked to the homoeostatic functions of the endothelium. Damage to the glycocalyx precedes vascular pathology. In the first part of this paper, we have reviewed the structure, physiology and pathology of the endothelial glycocalyx, based on a literature search of the past five years. In the second part, we have systematically reviewed interventions to protect or repair the glycocalyx. Glycocalyx damage can be caused by hypervolaemia and hyperglycaemia and can be prevented by maintaining a physiological concentration of plasma protein, particularly albumin. Other interventions have been investigated in animal models: these require clinical research before their introduction into medical practice.
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We identified direct evidence from 14 RCTs (n = 4,499 patients) that assessed use of procalcitonin to guide antimicrobial treatment duration in patients with sepsis.
“We identified direct evidence from 14 RCTs (n = 4,499 patients) that assessed use of procalcitonin to guide antimicrobial treatment duration in patients with sepsis (two trials included critically ill patients in general) (308-321).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [316]
Recent evidence suggests that IV fluids used to restore organ perfusion may damage vascular integrity and lead to organ dysfunction.
“recent evidence suggests that IV fluids used to restore organ perfusion may damage vascular integrity and lead to organ dysfunction [394].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [394]
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- Authors
- Alphonsus, C. S., & Rodseth, R. N.
- Affiliations
- Department of Anaesthesia Inkosi Albert Luthuli Central Hospital Durban South Africa
- Grey's Hospital (ZA)
- Venue
- Anaesthesia
- Publisher
- Wiley
- Published
- 2014-04-28
- Volume
- 69
- Issue
- 7
- Pages
- 777-784
- ISSN
- 0003-2409 (ISSN-L)
- 1365-2044
- OpenAlex
- W2070244277
- Cited by
- 460
- References
- 51
- Citations by year
- 2026: 27 · 2025: 27 · 2024: 48 · 2023: 48 · 2022: 48 · 2021: 51 · 2020: 50 · 2019: 42 · 2018: 43 · 2017: 25 · 2016: 28 · 2015: 16 · 2014: 5 · 2013: 1
- FWCI
- 2.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Anaesthesia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Proteoglycans and glycosaminoglycans research
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Life Sciences › Neuroscience › Neurology › Barrier Structure and Function Studies
- Keywords
- endothelial glycocalyx, vascular barrier, endothelial dysfunction, fluid overload, hyperglycemia, serum albumin, plasma protein levels, endothelial homeostasis
- MeSH terms
- Animals, Endothelium, Vascular, Humans, Hyperglycemia, Glycocalyx
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