Effect of Hydroxyethyl Starch Loading on Glycocalyx Shedding and Cerebral Metabolism During Surgery

Human glycocalyx shedding: Systematic review and critical appraisal

“…105 The common pattern is that several glycocalyx biomarkers become elevated, but in some studies only sdc-1 was increased and not HS. 101,122,126,178,189 This is surprising since syndecan-1 carries predominantly HS on its core protein and both markers would be expected to be correlated in plasma concentrations. However, this finding might be due to analytical error since syndecan-1 is stable in saved samples over time while heparan sulfate is more fragile, in particular if not consistently stored at −70°C until analyzed.…”

“…The common pattern is that several glycocalyx biomarkers become elevated, but in some studies only sdc‐1 was increased and not HS 101,122,126,178,189 . This is surprising since syndecan‐1 carries predominantly HS on its core protein and both markers would be expected to be correlated in plasma concentrations.…”

Resuscitation fluids as drugs: targeting the endothelial glycocalyx

“…In vitro Cheung-Flynn et al (2019) [30] Balanced crystalloid Harmful NS Animal Byrne et al (2018) [18] -Harmful NS Animal Torres et al (2017) [31] LR, Albumin, FFP Harmful Balanced crystalloid Animal Ergin et al (2020) [34] NS Beneficial Balanced crystalloid Animal Guerci et al (2019) [35] NS Harmful HES Animal Zhao et al (2020) [40] -Beneficial HES, albumin Clinical Li et al (2020) [41] -May be beneficial HES Clinical Kaneko et al (2020) [42] -Uncertain HES Animal Smart et al (2018) [43] FWB Beneficial Gelatin Animal Smart et al (2018) [43] FWB Harmful Isotonic crystalloids Animal Smart et al (2018) [43] FWB Harmful Gelatin, dextran -Smart and Hughes (2021) [44] -Uncertain HES Animal Wong et al (2016) [49] -Harmful Albumin Animal Wong et al (2016) [49] HES Beneficial 20% Albumin Animal Damiani et al (2016) [52] 4% Albumin More beneficial NS, balanced crystalloid Animal Torres et al (2017) [31] FFP, Albumin Harmful 5% Albumin, HES Clinical Suzuki and Koyama (2020) [53] -Beneficial Albumin Clinical Piotti et al (2021) [54] -Beneficial Albumin Clinical Hariri et al (2018) [55] -Beneficial Albumin Animal, In vitro Pati et al (2016) [57] FFP Little effect Albumin Clinical Yanase et al (2021) [58] -No effect FFP Animal Nikolian et al (2017) [60] NS Beneficial FFP Animal, In vitro Wu et al (2017) [17] -Beneficial LR plus FFP Animal Vigiola et al (2019) [62] LR, LR plus albumin Beneficial FFP Clinical Straat et al (2015) [63] -Beneficial Plasma Clinical Wei et al (2018) [64] Balanced crystalloids Uncompleted OctaplasLG Clinical Stensballe et al (2018) [65] FFP More beneficial FFP Animal Nelson et al (2016) [66] Albumin, RA No difference FFP: Fresh frozen plasma; FWB: Fresh whole blood; HES: Hydroxyethyl starch; LR: Lactated Ringer solution; NS: Normal saline; OctaplasLG: Solvent-/ detergent-treated pooled plasma; RA: Ringer acetate; -: Not available.…”

“…Zhao et al [ 40 ] confirmed that HES can protect the glycocalyx integrity and that this protective effect is associated with the down-regulated expression of heparinase, hyaluronidase, and neuraminidase. Li et al [ 41 ] speculated that 6% HES and albumin might protect the glycocalyx integrity in patients undergoing brain surgery, excluding the factor of fluid overload. Kaneko et al [ 42 ] also found that HES administration did not aggravate the glycocalyx degradation in patients undergoing abdominal surgery.…”

“…Some clinical studies have also been conducted to explore the effect of albumin and balanced crystalloids on the glycocalyx. Li et al [ 41 ] suggested that albumin may protect the glycocalyx integrity in patients undergoing brain surgery. Suzuki and Koyama [ 53 ] found that 5% albumin could exert a protective effect on the glycocalyx integrity in patients undergoing hepatic or pancreatic surgery.…”