The glycocalyx as a permeability barrier: basic science and clinical evidence
- Resource Type
- article
- Authors
- Randal O. Dull; Robert G. Hahn
- Source
- Critical Care, Vol 26, Iss 1, Pp 1-8 (2022)
- Subject
- Anesthesia
Capillaries
Glycocalyx
Human studies
Permeability
Fluid kinetics
Medical emergencies. Critical care. Intensive care. First aid
RC86-88.9
- Language
- English
- ISSN
- 1364-8535
Abstract Preclinical studies in animals and human clinical trials question whether the endothelial glycocalyx layer is a clinically important permeability barrier. Glycocalyx breakdown products in plasma mostly originate from 99.6–99.8% of the endothelial surface not involved in transendothelial passage of water and proteins. Fragment concentrations correlate poorly with in vivo imaging of glycocalyx thickness, and calculations of expected glycocalyx resistance are incompatible with measured hydraulic conductivity values. Increases in plasma breakdown products in rats did not correlate with vascular permeability. Clinically, three studies in humans show inverse correlations between glycocalyx degradation products and the capillary leakage of albumin and fluid.