Back to Search
Start Over
The endothelial glycocalyx and perioperative lung injury.
- Source :
-
Current opinion in anaesthesiology [Curr Opin Anaesthesiol] 2017 Feb; Vol. 30 (1), pp. 36-41. - Publication Year :
- 2017
-
Abstract
- Purpose of Review: Ventilator-induced lung injury is a major contributor to perioperative lung injury. The end-expiratory lung volume, regional lung overdistension, and tidal recruitment are known to be the main factors causing subsequent alveolar damage and inflammation. The alveolar-capillary membrane including the endothelial glycocalyx as an integral part of the vascular endothelium seems to play a major role in different kinds of lung injury.<br />Recent Findings: Recent studies underline the pivotal importance of the endothelial glycocalyx in lung injury. The glycocalyx regulates and modulates plasma endothelial cell interactions. Several triggers are known to deteriorate the gylcocalyx such as fluid overload, ischemia, and TRALI. The clinical manifestation is inflammation, capillary leak, and edema formation. Breakdown of the endothelial gylcocalyx is of gaining importance in the context of one-lung ventilation, known to be a major risk factor for postoperative lung injury. Studies suggest that volatile anesthetics may have a protective influence on the endothelial glycocalyx of pulmonary capillaries and reduce ischemia-reperfusion injury. This might be of clinical relevance for postoperative outcome.<br />Summary: This review focuses on the involvement of the pulmonary endothelial glycocalyx in the context of perioperative lung injury. The pathophysiological mechanisms and trigger factors of glycocalyx deterioration are discussed, and prevention strategies are taken into consideration.
- Subjects :
- Capillary Permeability
Endothelium blood supply
Endothelium cytology
Humans
Incidence
Lung blood supply
Lung cytology
Perioperative Period
Postoperative Complications epidemiology
Postoperative Complications etiology
Postoperative Complications pathology
Postoperative Complications prevention & control
Respiration, Artificial methods
Ventilator-Induced Lung Injury epidemiology
Ventilator-Induced Lung Injury etiology
Ventilator-Induced Lung Injury prevention & control
Endothelium injuries
Glycocalyx pathology
Lung pathology
Respiration, Artificial adverse effects
Ventilator-Induced Lung Injury pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1473-6500
- Volume :
- 30
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Current opinion in anaesthesiology
- Publication Type :
- Academic Journal
- Accession number :
- 27941354
- Full Text :
- https://doi.org/10.1097/ACO.0000000000000434