Protective Treatments against Endothelial Glycocalyx Degradation in Surgery: A Systematic Review and Meta-Analysis
| Autor: | Gwendolen C. Reilly, Hasnain Q. R. B. Khan |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Technology
medicine.medical_specialty QH301-705.5 QC1-999 fluid loading endothelial glycocalyx Inflammation Vascular permeability 030204 cardiovascular system & hematology Placebo post-operative surgery Glycocalyx 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine albumin extravasation medicine General Materials Science 030212 general & internal medicine Biology (General) QD1-999 Instrumentation Fluid Flow and Transfer Processes business.industry Physics Process Chemistry and Technology General Engineering inflammatory response Engineering (General). Civil engineering (General) Ulinastatin Extravasation Computer Science Applications Surgery Chemistry Methylprednisolone chemistry Biomarker (medicine) TA1-2040 medicine.symptom business medicine.drug |
| Zdroj: | Applied Sciences, Vol 11, Iss 6994, p 6994 (2021) |
| ISSN: | 2076-3417 |
| DOI: | 10.3390/app11156994 |
| Popis: | The aim was to explore the body of literature focusing on protective treatments against endothelial glycocalyx degradation in surgery. A comprehensive systematic review of relevant articles was conducted across databases. Inclusion criteria: (1) treatments for the protection of the endothelial glycocalyx in surgery; (2) syndecan-1 used as a biomarker for endothelial glycocalyx degradation. Outcomes analysed: (1) mean difference of syndecan-1 (2) correlation between glycocalyx degradation and inflammation; (3) correlation between glycocalyx degradation and extravasation. A meta-analysis was used to present mean differences and 95% confidence intervals. Seven articles with eight randomised controlled trials were included. The greatest change from baseline values in syndecan-1 concentrations was generally from the first timepoint measured post-operatively. Interventions looked to either dampen the inflammatory response or fluid therapy. Methylprednisolone had the highest mean difference in plasma syndecan-1 concentrations. Ulinastatin showed correlations between alleviation of degradation and preserving vascular permeability. In this systematic review of 385 patients, those treated were more likely than those treated with placebo to exhibit less shedding of the endothelial glycocalyx. Methylprednisolone has been shown to specifically target the transient increase of glycocalyx degradation immediately post-operation and has displayed anti-inflammatory effects. We have proposed suggestions for improved uniformity and enhanced confidence for future randomised controlled trials. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|