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Quantifying the Mechanical Properties of the Endothelial Glycocalyx with Atomic Force Microscopy
Published on: February 21, 2013
Endothelial glycocalyx thickness in cats with naturally occurring trauma or non-traumatic illness: an exploratory
Ivayla D Yozova1, Neroli Thomson1, Mitsuhiro Irie2
1School of Veterinary Science, Massey University, Palmerston North, New Zealand.
Introduction:
Endothelial glycocalyx damage contributes to morbidity and mortality in critical illness. In this exploratory study in cats with trauma and non-traumatic illness, the endothelial glycocalyx thickness was estimated using sidestream dark field videomicroscopy and the Glycocheck™ software, with the primary aims of assessing feasibility, describing of Glycocheck™ microcirculatory parameters and exploring potential effects of illness severity and IV fluid administration.
Methods:
This was a prospective, single center, observational study. Recorded variables included age, weight, diagnosis, length of hospitalization (LOH), packed cell volume (PCV) and IV fluid administration. Each patient was assigned a fast Acute Patient Physiologic and Laboratory Evaluation score (APPLEfast) and for cats with trauma - Animal Trauma Triage score (ATT). Within 24 h from admission, cats were anesthetized, and images from the sublingual mucosal vessels obtained for Glycocheck™ analysis. The perfused boundary region (PBR), an inverse estimate for endothelial glycocalyx thickness, was calculated for vessels with diameter of 5-25, 5-9, 10-19 and 20-25 μm, respectively. Normality was assessed using Shapiro-Wilk test and histograms. The effects of APPLEfast, LOH, ATT, PCV, IV fluid administration, and illness group on PBR were analysed using generalised linear models. Distribution of vascular segment counts was assessed using Friedman's test and Wilcoxon rank-signed test.
Results:
Nineteen cats were included, 11 with trauma. Success rate for measurements was 95%. Survival to discharge was 95%. Mean ± standard deviation for PBR 5-25 was 2.60 ± 0.22 μm, PBR 5-9: 1.38 ± 0.15 μm, PBR 10-19: 3.02 ± 0.22 μm and PBR 20-25: 3.03 ± 0.38 μm, within previously established tolerance intervals. There were no statistically significant effects of group, LOH, ATT, APPLEfast, PCV and IV fluids on any PBR measurements. Vascular segment counts across the 5-25 μm range were not equally distributed (p < 0.001).
Conclusion:
This exploratory study demonstrates the feasibility of assessing endothelial glycocalyx thickness in hospitalized sick cats. While no effects of clinical variables on PBR were identified, the study highlights important methodological considerations and provides valuable insights to guide future, larger-scale investigations.
