Abstract
PURPOSE: Endothelial glycocalyx (EG) shedding may promote organ failure in sepsis. This study describes temporal changes in EG biomarkers from Emergency Department (ED) arrival, and associations with clinical characteristics.
MATERIALS AND METHODS: This prospective observational study included 23 patients with simple infection, 86 with sepsis and 29 healthy controls. Serum EG biomarkers included syndecan-1, syndecan-4 and hyaluronan. Samples were taken on enrolment in the ED (T0), 1 hour (T1), 3 hours (T3) and 12 to 24 hours (T24) later.
RESULTS: Syndecan-1 concentration increased incrementally over time (T0-T24, both patient groups, P < .001) whereas hyaluronan concentration peaked at T3 (T0-T3, sepsis group, P < .001). Hyaluronan was positively associated with cumulative fluid volumes (P < .001) at T0, T1, and T3, independent of illness severity. Both syndecan-1 (OR 1.04, 95% CI 1.01-1.07, P = .017) and hyaluronan (OR 1.83, 95% CI 1.46-2.30, P < .001) were associated with organ failure, independent of age and comorbidity. Syndecan-4 concentration was not different between groups or over time.
CONCLUSIONS: In contrast to previous ICU studies, EG biomarkers increased during the first 24 hours of sepsis treatment and were associated with fluid volumes and organ failure. Further investigation is required to determine if interventions delivered in the ED contribute to EG shedding.
| Original language | English |
|---|---|
| Pages (from-to) | 304-309 |
| Number of pages | 6 |
| Journal | Journal of Critical Care |
| Volume | 42 |
| DOIs | |
| Publication status | Published - Dec 2017 |
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Endothelial glycocalyx biomarkers increase in patients with infection during Emergency Department treatment. / Smart, Lisa; Macdonald, Stephen P J; Burrows, Sally; Bosio, Erika; Arendts, Glenn; Fatovich, Daniel M.
In: Journal of Critical Care, Vol. 42, 12.2017, p. 304-309.Research output: Contribution to journal › Article
TY - JOUR
T1 - Endothelial glycocalyx biomarkers increase in patients with infection during Emergency Department treatment
AU - Smart, Lisa
AU - Macdonald, Stephen P J
AU - Burrows, Sally
AU - Bosio, Erika
AU - Arendts, Glenn
AU - Fatovich, Daniel M
N1 - Copyright © 2017 Elsevier Inc. All rights reserved.
PY - 2017/12
Y1 - 2017/12
N2 - PURPOSE: Endothelial glycocalyx (EG) shedding may promote organ failure in sepsis. This study describes temporal changes in EG biomarkers from Emergency Department (ED) arrival, and associations with clinical characteristics.MATERIALS AND METHODS: This prospective observational study included 23 patients with simple infection, 86 with sepsis and 29 healthy controls. Serum EG biomarkers included syndecan-1, syndecan-4 and hyaluronan. Samples were taken on enrolment in the ED (T0), 1 hour (T1), 3 hours (T3) and 12 to 24 hours (T24) later.RESULTS: Syndecan-1 concentration increased incrementally over time (T0-T24, both patient groups, P < .001) whereas hyaluronan concentration peaked at T3 (T0-T3, sepsis group, P < .001). Hyaluronan was positively associated with cumulative fluid volumes (P < .001) at T0, T1, and T3, independent of illness severity. Both syndecan-1 (OR 1.04, 95% CI 1.01-1.07, P = .017) and hyaluronan (OR 1.83, 95% CI 1.46-2.30, P < .001) were associated with organ failure, independent of age and comorbidity. Syndecan-4 concentration was not different between groups or over time.CONCLUSIONS: In contrast to previous ICU studies, EG biomarkers increased during the first 24 hours of sepsis treatment and were associated with fluid volumes and organ failure. Further investigation is required to determine if interventions delivered in the ED contribute to EG shedding.
AB - PURPOSE: Endothelial glycocalyx (EG) shedding may promote organ failure in sepsis. This study describes temporal changes in EG biomarkers from Emergency Department (ED) arrival, and associations with clinical characteristics.MATERIALS AND METHODS: This prospective observational study included 23 patients with simple infection, 86 with sepsis and 29 healthy controls. Serum EG biomarkers included syndecan-1, syndecan-4 and hyaluronan. Samples were taken on enrolment in the ED (T0), 1 hour (T1), 3 hours (T3) and 12 to 24 hours (T24) later.RESULTS: Syndecan-1 concentration increased incrementally over time (T0-T24, both patient groups, P < .001) whereas hyaluronan concentration peaked at T3 (T0-T3, sepsis group, P < .001). Hyaluronan was positively associated with cumulative fluid volumes (P < .001) at T0, T1, and T3, independent of illness severity. Both syndecan-1 (OR 1.04, 95% CI 1.01-1.07, P = .017) and hyaluronan (OR 1.83, 95% CI 1.46-2.30, P < .001) were associated with organ failure, independent of age and comorbidity. Syndecan-4 concentration was not different between groups or over time.CONCLUSIONS: In contrast to previous ICU studies, EG biomarkers increased during the first 24 hours of sepsis treatment and were associated with fluid volumes and organ failure. Further investigation is required to determine if interventions delivered in the ED contribute to EG shedding.
KW - Journal Article
U2 - 10.1016/j.jcrc.2017.07.001
DO - 10.1016/j.jcrc.2017.07.001
M3 - Article
VL - 42
SP - 304
EP - 309
JO - Journal of Critical Care
JF - Journal of Critical Care
SN - 0883-9441
ER -