Targeting the endothelial glycocalyx in acute critical illness as a challenge for clinical and laboratory medicine
Jazyk angličtina Země Velká Británie, Anglie Médium print-electronic
Typ dokumentu časopisecké články, přehledy
- Klíčová slova
- Endothelial glycocalyx, anesthesia, critically-ill, endothelium, fluids, surgery,
- MeSH
- endoteliální buňky * cytologie fyziologie MeSH
- glykokalyx * chemie fyziologie MeSH
- klinické laboratorní techniky * MeSH
- kritický stav * MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
The purpose of this manuscript is to review the role of endothelial glycocalyx (EG) in the field of critical and perioperative medicine and to discuss possible future directions for investigations in this area. Under physiological conditions, EG has several well-defined functions aimed to prevent the disruption of vessel wall integrity. Under pathological conditions, the EG represent one of the earliest sites of injury during inflammation. EG structure and function distortion contribute to organ dysfunction related to sepsis, trauma, or global ischemia of any origin. Discovering new therapeutic approaches (either pharmacological or non-pharmacological) aimed to protect the EG against injury represents a promising direction in clinical medicine. Further, the currently-used common interventions in the acutely ill - fluids, blood products, nutritional support, organ-supporting techniques (e.g. continuous renal replacement therapy, extracorporeal circulation), temperature modulation and many others - should be re-evaluated during acute illness in terms of their EG "friendliness". To assess new therapies that protect the EG, or to evaluate the effect of currently-used interventions on EG integrity, a relevant marker or method to determine EG damage is needed. Such marker or method should be available to clinicians within hours, preferably in the form of a point-of-care test at the bedside. Collaborative research between clinical disciplines and laboratory medicine is warranted, and targeting the EG represents major challenges for both.
b Centrum for Research and Development University Hospital Hradec Kralove Czech Republic
g Biomedical Centre Charles University Faculty of Medicine in Plzen Plzen Czech Republic
h Department of Microbiology and Immunology Dalhousie University Halifax Canada
i Department of Pharmacology Dalhousie University Halifax Canada
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