The role of endothelial shear stress on haemodynamics, inflammation, coagulation and glycocalyx during sepsis

Lupu, Florea; Kinasewitz, Gary T.; Dormer, Kenneth J.

doi:10.1111/jcmm.15895

Cited by 93 publications

(85 citation statements)

References 124 publications

(222 reference statements)

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“… 30 After VEG injury, the fluid flow in the capillaries greatly exceeds reabsorption, leading to interstitial edema and local ischemia, accelerating tissue ischemia, which eventually leads to organ dysfunction. 31 All above mentioned mechanisms shown in Figure 3 lead to an increase in the incidence of sepsis and mortality in trauma patients with high HbA1c. In addition to our research, there are other studies on the above mechanism.…”

Section: Discussionmentioning

confidence: 99%

Glycosylated Hemoglobin as a Predictor of Sepsis and All-Cause Mortality in Trauma Patients

Guo¹,

Shen²

2021

IDR

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Background and Purpose Infection is a common comorbidity and cause of death in emergency trauma patients, especially in diabetic patients. Once the patients are admitted, they are more susceptible to further complications like sepsis and resultant increase in in-hospital mortality. Therefore, it is necessary to evaluate risk factors associated with sepsis after trauma and death in trauma patients. Methods A total of 397 trauma patients were divided into 2 groups according to HbA1c level, HbA1c: <6.5% (n = 259), HbA1c: >6.5% (n = 138), and baseline clinical characteristics were collected. The independent risk factors of sepsis associated with trauma were screened using univariate and multivariate logistic regression analysis. Cox proportional hazards regression analysis was used to investigate risk factors for 30-day all-cause mortality. Results The sepsis incidence (76.1% vs 35.9%, P<0.001) and mortality rate (29.7% vs 7.3%, P<0.001) were significantly higher in HbA1c>6.5% group. Multivariate logistic regression analysis revealed that the independent risk factors of sepsis after trauma were diabetes (OR: 3.1, 95% CI: 1.41–6.79), hypertension (OR: 2.55, 95% CI: 1.35–4.82), coagulation disorder (OR: 3.45, 95% CI: 1.23–9.67), creatinine (OR: 3.71, 95% CI: 1.66–8.31), urea nitrogen (OR: 0.96, 95% CI: 0.92–0.99), HbA1c%>6.5 (OR: 2.05, 95% CI: 1.65–2.54), increase in body mass index (OR: 1.08, 95% CI: 1.03–1.13) and lower initial GCS score (OR: 0.93, 95% CI: 0.88–0.99). Multivariable Cox proportional hazard analysis revealed that male (HR: 1.94, 95% CI: 1.21–3.12), HbA1c >6.5% (HR: 1.45, 95% CI: 1.32–1.6), albumin (HR: 0.54, 95% CI: 0.34–0.86), creatinine (HR: 1.02, 95% CI: 1.01–1.03), APTT (HR: 1.02, 95% CI: 1.01–1.03), SOFA score (HR: 1.2, 95% CI: 1.1–1.31), age >65 years (HR: 3.21, 95% CI: 1.95–5.3) were independent risk factor for trauma patients’ mortality. Conclusion The prevalence of sepsis and mortality was higher in trauma patients with HbA1c >6.5%. HbA1c was independent risk factor for sepsis and all cases of mortality in trauma patients.

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Section: Discussionmentioning

confidence: 99%

Glycosylated Hemoglobin as a Predictor of Sepsis and All-Cause Mortality in Trauma Patients

Guo¹,

Shen²

2021

IDR

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“…Sepsis reduces vessel wall shear stress leading to microcirculatory dysfunction, loss of anticoagulation and increased local blood viscosity. 2 Additionally, sepsis has been shown to increase inflammatory cytokine expression localised to the aortic lumen of mice even during its early presentation (measured at 72 hours and 120 hours) with resultant increased atheroma at 5 months follow-up. 3 Existing atheroma (due to atherosclerosis) through intimal injury can become nidus for infection in sepsis and predisposes to aortitis.…”

Section: Images In…mentioning

confidence: 99%

Acute aortic dissection in sepsis withStaphylococcusbacteraemia

Rehan¹,

Ha²,

Uddin

2021

BMJ Case Rep

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“…The vascular endothelium serves as the first barrier, thereby providing protection against the effects of inflammation. Damage to the glycocalyx layer is thought to be initial stage in the development of inflammation ( Lupu et al, 2020 ). The glycocalyx is connected to the endothelium by backbone molecules, including proteoglycans and glycoproteins.…”

Section: Introductionmentioning

confidence: 99%

Glycocalyx Impairment in Vascular Disease: Focus on Inflammation

Cheng

et al. 2021

Front. Cell Dev. Biol.

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The glycocalyx is a complex polysaccharide-protein layer lining the lumen of vascular endothelial cells. Changes in the structure and function of the glycocalyx promote an inflammatory response in blood vessels and play an important role in the pathogenesis of many vascular diseases (e.g., diabetes, atherosclerosis, and sepsis). Vascular endothelial dysfunction is a hallmark of inflammation-related diseases. Endothelial dysfunction can lead to tissue swelling, chronic inflammation, and thrombosis. Therefore, elimination of endothelial inflammation could be a potential target for the treatment of vascular diseases. This review summarizes the key role of the glycocalyx in the inflammatory process and the possible mechanism by which it alleviates this process by interrupting the cycle of endothelial dysfunction and inflammation. Especially, we highlight the roles of different components of the glycocalyx in modulating the inflammatory process, including components that regulate leukocyte rolling, L-selectin binding, inflammasome activation and the signaling interactions between the glycocalyx components and the vascular cells. We discuss how the glycocalyx interferes with the development of inflammation and the importance of preventing glycocalyx impairment. Finally, drawing on current understanding of the role of the glycocalyx in inflammation, we consider a potential strategy for the treatment of vascular diseases.

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The role of endothelial shear stress on haemodynamics, inflammation, coagulation and glycocalyx during sepsis

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 93 publications

References 124 publications

Glycosylated Hemoglobin as a Predictor of Sepsis and All-Cause Mortality in Trauma Patients

Glycosylated Hemoglobin as a Predictor of Sepsis and All-Cause Mortality in Trauma Patients

Acute aortic dissection in sepsis withStaphylococcusbacteraemia

Glycocalyx Impairment in Vascular Disease: Focus on Inflammation

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