Table 2 The endothelial surface layer
From: Regulation of blood flow and volume exchange across the microcirculation
A) Functions • Regulation of vascular permeability • Mediation of shear stress • Attenuation of leukocyte and platelet adhesion • Binding of cytokines/chemokines, hormones, etc. | |
B) Scenarios of damage • Ischemia/reperfusion, hypoxia, shock • Inflammation • Volume loading • Chronic heart failure (due to release of natriuretic peptides) • Atherosclerosis and diabetes • Radiation (?) | |
C) Present and potential future strategies of clinical protection • Plasma albumin in organ transplantation • Hydrocortisone and mast cell inhibition • Direct cytokine inhibition • Antithrombin and protease inhibitors • Avoidance strategies (antioxidants, normovolemia) • Supply of “prefabs” (e.g., heparinoids, Danaparoid) • Anesthetic regimens (e.g., sevoflurane) |