Science‐in‐brief: The role of the glycocalyx in critically ill patients with reference to the horse

Abstract

The glycocalyx, a gel-like layer covering the luminal surface of vascular endothelial cells has several key functions in maintaining homeostasis in the vasculature. Interest in the glycocalyx has significantly increased in the last decades and damage to this vital layer appears to influence progression and recovery in many disease processes. Pathological injury to the glycocalyx occurs in ischaemia–reperfusion, inflammation, sepsis, shock, burns and excessive shear stress. There is increasing evidence that iatrogenic interventions such as fluid therapy influence the integrity of the glycocalyx and can even worsen the initial injury from pathological events. Rapid infusion of crystalloids and colloids, hypervolaemia, hypernatraemia and hyperglycaemia have all been associated with increased glycocalyx shedding. Current treatment recommendations aim to minimise iatrogenic damage. In the future, interventions aimed at restoring glycocalyx integrity and function might become valuable tools in critical care.