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Fluid resuscitation and markers of glycocalyx degradation in severe sepsis

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机构: [1]Hebei Med Univ, Hosp 4, Dept Gastrointestinal Surg, Shijiazhuang 050011, Hebei, Peoples R China [2]Hebei Med Univ, Hosp 4, Dept ICU, Shijiazhuang, Hebei, Peoples R China
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关键词: Fluid resuscitation Glycocalyx Severe sepsis

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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.

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出版当年[2017]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
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出版当年[2017]版:
Q4 MEDICINE, GENERAL & INTERNAL
最新[2024]版:
Q2 MEDICINE, GENERAL & INTERNAL

影响因子: 最新[2024版] 最新五年平均 出版当年[2017版] 出版当年五年平均 出版前一年[2016版] 出版后一年[2018版]

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第一作者机构: [2]Hebei Med Univ, Hosp 4, Dept ICU, Shijiazhuang, Hebei, Peoples R China
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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
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