The association between hypoalbuminemia and microcirculation, endothelium, and glycocalyx disorders in children with sepsis.

Autor: Fernández-Sarmiento J; Department of Critical Care Medicine and Pediatrics, Universidad de La Sabana Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia., Hernández-Sarmiento R; Department of Critical Care Medicine and Pediatrics, Universidad de La Sabana Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia., Salazar MP; Department of Critical Care Medicine and Pediatrics, Universidad de La Sabana Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia., Barrera S; Department of Critical Care Medicine and Pediatrics, Universidad de La Sabana Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia., Castilla V; Department of Pediatrics Fundación Cardioinfantil-Instituo de Cardiología, Universidad del Rosario, Bogotá, Colombia., Duque C; Department of Critical Care Medicine and Pediatrics, Universidad de La Sabana Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia.
Jazyk: angličtina
Zdroj: Microcirculation (New York, N.Y. : 1994) [Microcirculation] 2023 Nov; Vol. 30 (8), pp. e12829. Date of Electronic Publication: 2023 Aug 28.
DOI: 10.1111/micc.12829
Abstrakt: Objective: The objective of this study was to evaluate the association between serum albumin levels and microcirculation changes, glycocalyx degradation, and the clinical outcomes of interest.
Methods: Observational, prospective study in children with sepsis. The primary outcome was the association between hypoalbuminemia and microcirculation disorders, endothelial activation and glycocalyx degradation using a perfused boundary region (PBR) (abnormal >2.0 μm on sublingual video microscopy) or plasma biomarkers (syndecan-1, angiopoietin-2).
Results: A total of 125 patients with sepsis were included. The median age was 2.0 years (IQR 0.5-12.5). Children with hypoalbuminemia had more abnormal microcirculation with a higher PBR (2.16 μm [IQR 2.03-2.47] vs. 1.92 [1.76-2.28]; p = .01) and more 4-6 μm capillaries recruited (60% vs. 40%; p = .04). The low albumin group that had the worst PBR had the most 4-6 μm capillaries recruited (rho 0.29; p < .01), 48% higher Ang-2 (p = .04), worse annexin A5 (p = 0.03) and no syndecan-1 abnormalities (p = .21). Children with hypoalbuminemia and a greater percentage of blood volume in their capillaries needed mechanical ventilation more often (56.3% vs. 43.7%; aOR 2.01 95% CI 1.38-3.10: p < .01).
Conclusions: In children with sepsis, an association was found between hypoalbuminemia and microcirculation changes, vascular permeability, and greater endothelial glycocalyx degradation.
(© 2023 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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