Evaluation of resuscitation fluids on endothelial glycocalyx, venular blood flow, and coagulation function after hemorrhagic shock in rats

  title={Evaluation of resuscitation fluids on endothelial glycocalyx, venular blood flow, and coagulation function after hemorrhagic shock in rats},
  author={Luciana N. Torres and Jill L. Sondeen and Lisa Liping Ji and Michael A. Dubick and Ivo P. Torres Filho},
  journal={Journal of Trauma and Acute Care Surgery},
BACKGROUND Endothelial glycocalyx (EG) plays an essential role in endothelium integrity and may be compromised by hemorrhagic shock. The effects of currently available resuscitation fluids such as Hextend (HEX) or lactated Ringer’s solution (LR) on vascular function and coagulation are not well understood. The aim of the present study was to compare the effects of fresh frozen plasma (FFP) with HEX or LR in their ability to repair EG structure, promote volume expansion, increase blood flow, and… 

Systemic and microvascular effects of resuscitation with blood products after severe hemorrhage in rats

Data suggest that the removal of residual plasma protein from wPRBC or resuscitation with a protein-free solution (LR) is not able to improve microcirculation and coagulation functions in this severe hemorrhage model.

Effect of Coagulation Factor Concentrates on Markers of Endothelial Cell Damage in Experimental Hemorrhagic Shock.

It was revealed that plasma-based resuscitation normalized circulating heparan sulfate but not syndecan-1, suggesting a lack of its therapeutic potential in this in vivo study.

Glycocalyx Degradation Is Independent of Vascular Barrier Permeability Increase in Nontraumatic Hemorrhagic Shock in Rats.

It is hypothesized that the shedding of the glycocalyx during NTHS has little effect on VBP and that the composition of fluids can modulate these effects and the concept that the glycocalypsex barrier is a significant contributor to VBP is challenged.

The Role of Plasma Transfusion in Massive Bleeding: Protecting the Endothelial Glycocalyx?

Current knowledge on glycocalyx structure and function is summarized, data describing the impact of hemorrhagic shock and resuscitation fluids on glyocalyx are presented, and the possible plasma components responsible for these effects are presented.

Poor microcirculatory flow dynamics are associated with endothelial cell damage and glycocalyx shedding after traumatic hemorrhagic shock

Endothelial cell damage and glycocalyx shedding are associated with worse flow, density, and heterogeneity within microvessels after traumatic hemorrhagic shock and their clinical utility is yet to be elucidated.

Plasma syndecan-1 and heparan sulfate correlate with microvascular glycocalyx degradation in hemorrhaged rats after different resuscitation fluids.

A quantitative framework is provided supporting plasma syndecan-1 and heparan sulfate as valuable clinical biomarkers of glycocalyx shedding that may be useful in guiding resuscitation strategies following hemorrhage.

Hemorrhagic Shock and Resuscitation Causes Glycocalyx Shedding and Endothelial Oxidative Stress Preferentially in the Lung and Intestinal Vasculature

The endothelium in the lungs and intestine are particularly susceptible to the oxidative stress of hemorrhage-resuscitation, as well as the resulting glycocalyx disruption, which concludes that these two vessel beds may be important drivers of coagulopathy in trauma patients.

Effects of fresh frozen plasma, Ringer’s acetate and albumin on plasma volume and on circulating glycocalyx components following haemorrhagic shock in rats

Improved outcome in trauma by FFP could in part be explained by better plasma volume expansion compared to crystalloids.

Large-Volume Crystalloid Fluid Is Associated with Increased Hyaluronan Shedding and Inflammation in a Canine Hemorrhagic Shock Model

In conclusion, rapid large-volume crystalloid administered for hemorrhagic shock was associated with increased hyaluronan and a greater inflammatory response.

Low-Volume Resuscitation for Hemorrhagic Shock: Understanding the Mechanism of PEG-20k

Data are consistent with the hypothesis that PEG-20k may act by establishing multiple osmotic gradients in the microcirculation to drive cell-to-capillary water transfer during hypovolemic shock.



Plasma Restoration of Endothelial Glycocalyx in a Rodent Model of Hemorrhagic Shock

The protective effects of plasma may be due in part to its ability to restore the endothelial glycocalyx and preserve syndecan-1 after hemorrhagic shock.


It is concluded that hemorrhagic shock caused accelerated fibrinogen breakdown and coagulation, and effective treatment of hemorrhage should include combining standard-of-care resuscitation with interventions to correct alterations in coagulating.

In vivo evaluation of venular glycocalyx during hemorrhagic shock in rats using intravital microscopy.

The Effects of Perioperatively Administered Colloids and Crystalloids on Primary Platelet-Mediated Hemostasis and Clot Formation

It is shown that colloid administration reduces final clot strength more than does RL alone, which also exhibited effects, albeit minor, on the coagulation system.

Shedding of the endothelial glycocalyx in arterioles, capillaries, and venules and its effect on capillary hemodynamics during inflammation.

Glycan shedding appears to be present at all levels of the microvascular tree, and may affect multiple physiological processes that involve flow dependent signal transduction and/or blood cell to EC adhesion.

Shedding of the Endothelial Glycocalyx in Patients Undergoing Major Vascular Surgery With Global and Regional Ischemia

This study provides the first evidence in humans for shedding of the endothelial glycocalyx during ischemia/reperfusion procedures and shows that this structure plays a key role in the regulation of inflammation and vascular permeability.

Microvascular and capillary perfusion following glycocalyx degradation.

Findings suggest that the decrease in the glycocalyx leads to capillary perfusion impairments.

Effects of synthetic versus natural colloid resuscitation on inducing dilutional coagulopathy and increasing hemorrhage in rabbits.

It is suggested that resuscitation with albumin maintained coagulation function, decreased blood loss, and improved survival time compared with the synthetic colloids.

Blood flow resistance during hemodilution: effect of plasma composition.