Links between Endothelial Glycocalyx Changes and Microcirculatory Parameters in Septic Patients

Area of Science:

• Cardiovascular Biology
• Microcirculation Research
• Sepsis Pathophysiology

Background:

• The endothelial glycocalyx is crucial for microvascular homeostasis.
• Impaired glycocalyx integrity is linked to microvascular dysfunction.

Purpose of the Study:

• To evaluate glycocalyx damage in sepsis patients.
• To correlate microcirculatory parameters with glycocalyx thickness in sepsis.

Main Methods:

• Prospective observational study of adult sepsis patients.
• Assessed sublingual microcirculation using Cytocam-incident dark field microscopy.
• Measured perfused boundary regions (PBRs) using GlycoCheck across vessel diameters (5-25 μm).

Main Results:

• Septic patients showed significant glycocalyx damage across all measured vessel diameters compared to controls.
• Smallest capillaries (5-9 μm) PBRs inversely correlated with blood vessel densities.
• Glycocalyx damage in small capillaries may functionally relate to sepsis-induced microcirculatory changes.

Conclusions:

• Endothelial glycocalyx damage is evident in sepsis.
• Damage to the glycocalyx in the smallest capillaries is associated with microcirculatory alterations in sepsis.