Changes in microcirculatory perfusion during cardiac surgery are paralleled by alterations in glycocalyx integrity

C Boer,J Van Teeffelen,Ab Vonk,Nj Koning,H Vink

doi:10.1186/cc12150

C Boer, J Van Teeffelen + Show 3 more

Open Access

https://doi.org/10.1186/cc12150

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Journal: Critical Care	Publication Date: Mar 19, 2013
Citations: 8	License type: CC BY 2.0

Affiliation: Amsterdam UMC Location VUmc, Maastricht University

Abstract

Previous studies demonstrate that loss of glycocalyx integrity is associated with impaired microvascular function. We investigated whether glycocalyx dimensions are reduced in patients undergoing cardiac surgery with or without cardiopulmonary bypass (CPB), and are paralleled by loss of microcirculatory perfusion using in vivo microcirculation measurements.

Highlights

Autophagy is well known as one of the biogenic responses against various stresses, which possesses the beneficial roles for survival, but little is known about the dynamics and its significance during the septic condition
community-acquired pneumonia (CAP)-mediated antiinflammatory signals in vagal efferent nerve fibers result in the release of acetylcholine, which interacts with innate immune cells that express the nicotinic acetylcholine receptor subunit α7 (α7nAChR)
Endothelial dysfunction during sepsis is responsible for increased endothelial permeability, leukocyte–endothelial interaction and functional breakdown of microvascular perfusion

Summary

Introduction

Autophagy is well known as one of the biogenic responses against various stresses, which possesses the beneficial roles for survival, but little is known about the dynamics and its significance during the septic condition. Conclusion The assessment of routine biomarkers (bilirubin, white blood cells and hemoglobin) may be a helpful tool in the decisionmaking process at the bedside, for the evaluation of early ICU admission of recoverable patients, as indicators of inflammatory response, organ dysfunction or catabolism level, and their significant predictive value on mortality. The purpose of this study was to ascertain the prognostic value of proadrenomedullin (pADM), measured in all patients admitted to the ICU of our hospital with a diagnosis of severe sepsis or septic shock during 1 year. The aim of the study is to evaluate life quality after trauma and to identify the most important needs of the patients, in order to improve the level of care after an ICU stay and to implement a faster and more effective reintegration into the active and productive society. We report the results of the baseline phase of this trial

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