Skip to main content
Fig. 1 | Critical Care

Fig. 1

From: Intravenous fluid resuscitation is associated with septic endothelial glycocalyx degradation

Fig. 1

Glycocalyx degradation occurs in patients with septic shock. a The endothelial glycocalyx is an apical endothelial layer composed of transmembrane proteoglycans (such as syndecan-1 and thrombomodulin) covalently attached to glycosaminoglycans (primarily heparan sulfate) that project into the vascular lumen. During sepsis, activation of heparanase and matrix metalloproteinases leads to glycocalyx degradation, releasing heparan sulfate and proteoglycan fragments into the plasma. b In a cohort of 56 septic shock patients enrolled in the ProCESS trial, circulating heparan sulfate levels were elevated in comparison to 15 non-infected ED controls. Measurements in septic patients were made 6 h after enrollment (i.e., after initial fluid resuscitation). c Of 56 septic patients, 8 patients eventually died during their hospitalization. There was a non-significant trend towards increased heparan sulfate concentrations (measured after 6 h resuscitation) in non-survivors. Circulating heparan sulfate concentrations (at 6 h) correlated with plasma concentrations of glycocalyx components syndecan-1 (d) and thrombomodulin (e) in septic shock patients. Line represents best fit line. f There was no association between plasma heparan sulfate and atrial natriuretic peptide (ANP) in septic shock patients after 6 h resuscitation. Parentheses in b, c represent number of patients in each group

Back to article page