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The Endothelial Glycocalyx: A Fundamental Determinant of Vascular Permeability in Sepsis

Jaime Fernández-Sarmiento1,2, Lina María Salazar-Peláez1, Joseph A Carcillo3

  • 1Division of Graduate School, Universidad CES, Basic Sciences Research Group, Medellín, Colombia.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|March 6, 2020
PubMed

Insights

The endothelial glycocalyx is crucial for regulating vascular permeability in children with sepsis. Further research is needed to understand how fluid resuscitation and other treatments impact this vital structure in pediatric sepsis.

Area of Science:

  • Cardiovascular Research
  • Pediatric Critical Care
  • Endothelial Biology

Background:

  • Sepsis significantly increases morbidity and mortality in children.
  • Pediatric sepsis involves microcirculatory dysfunction and increased vascular permeability.
  • The endothelial glycocalyx plays a key role in maintaining vascular integrity.

Purpose of the Study:

  • To review current evidence on the endothelial glycocalyx's role in capillary leakage in pediatric sepsis.
  • To understand glycocalyx alterations in sepsis and their impact on vascular permeability.
  • To explore the effects of resuscitation strategies on the glycocalyx in pediatric sepsis.

Main Methods:

  • Comprehensive literature search of PubMed, EMBASE, and Google Scholar.
  • Inclusion of studies in all languages, including animal and human research.
  • Keywords: glycocalyx, fluids, syndecan, endothelium, vascular permeability, edema, sepsis, septic shock, children.

Main Results:

  • The endothelial glycocalyx is a vital component of the endothelial barrier, regulating permeability.
  • Disruptions in the glycocalyx are linked to increased vascular permeability, particularly in sepsis.
  • The impact of fluid resuscitation and vasopressors on the glycocalyx in sepsis requires further investigation.

Conclusions:

  • The endothelial glycocalyx is a critical determinant of vascular permeability and mechanotransduction in pediatric sepsis.
  • More research is essential to evaluate interventions like fluid boluses and vasoactive support on endothelial integrity and the glycocalyx in pediatric sepsis.
Abstract

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