Background: The aim of this study was to determine the relationship between fluid resuscitation and glycocalyx degradation in severe sepsis. Methodology: 15 post-thoracotomy patients with severe sepsis and 11 patients in recovery after open chest surgery (controls) were enrolled. Results: Plasma syndecan-1 concentrations were significantly higher in the sepsis group than that in control group, and were correlated with fluid balance in the sepsis group (P=0.026). Survival was not related to trends in plasma syndecan-1 concentrations (ascending/descending) in the sepsis group (P = 0.409). Fluid balance at 24 h was significantly higher in sepsis patients who died than in those who survived (P = 0.010). Acute Physiology and Chronic Health Evaluation II scores, Sequential Organ Failure Assessment scores, duration of mechanical ventilation, and length of intensive care unit stay did not differ with the trend of plasma syndecan-1 concentrations. Compared with plasma syndecan-1 concentrations, lactate clearance at a cutoff of 0.40% had a higher diagnostic value. Conclusions: In patients with severe sepsis, the glycocalyx plays an important role in liquid distribution in different phases. With time, it changes as well. At present, lactate clearance has greater diagnostic value than plasma syndecan-1 concentrations in severe sepsis. A better indicator of endothelial glycocalyx is therefore required.
基金:
Health Department of Scientific Research Fund Project of Hebei Province [ZD20140134]
第一作者机构:[2]Hebei Med Univ, Hosp 4, Dept ICU, Shijiazhuang, Hebei, Peoples R China
通讯作者:
通讯机构:[1]Hebei Med Univ, Hosp 4, Dept Gastrointestinal Surg, Shijiazhuang 050011, Hebei, Peoples R China[*1]Departments of Gastrointestinal Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei, China
推荐引用方式(GB/T 7714):
Wu Xinhui,Hu Zhenjie,Yuan Hufang,et al.Fluid resuscitation and markers of glycocalyx degradation in severe sepsis[J].OPEN MEDICINE.2017,12(1):409-416.doi:10.1515/med-2017-0059.
APA:
Wu, Xinhui,Hu, Zhenjie,Yuan, Hufang,Chen, Lei,Li, Yong&Zhao, Congcong.(2017).Fluid resuscitation and markers of glycocalyx degradation in severe sepsis.OPEN MEDICINE,12,(1)
MLA:
Wu, Xinhui,et al."Fluid resuscitation and markers of glycocalyx degradation in severe sepsis".OPEN MEDICINE 12..1(2017):409-416