Endothelial glycocalyx biomarkers increase in patients with infection during Emergency Department treatment

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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 languageEnglish
Pages (from-to)304-309
Number of pages6
JournalJournal of Critical Care
Volume42
DOIs
Publication statusPublished - Dec 2017

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Glycocalyx
Emergency Treatment
Syndecan-1
Hospital Emergency Service
Hyaluronic Acid
Biomarkers
Sepsis
Syndecan-4
Infection
Organ Size
Observational Studies
Comorbidity
Prospective Studies
Serum
3-monoiodothyronine

Cite this

@article{7b135a83e7864334b22782df4b28b900,
title = "Endothelial glycocalyx biomarkers increase in patients with infection during Emergency Department treatment",
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.",
keywords = "Journal Article",
author = "Lisa Smart and Macdonald, {Stephen P J} and Sally Burrows and Erika Bosio and Glenn Arendts and Fatovich, {Daniel M}",
note = "Copyright {\circledC} 2017 Elsevier Inc. All rights reserved.",
year = "2017",
month = "12",
doi = "10.1016/j.jcrc.2017.07.001",
language = "English",
volume = "42",
pages = "304--309",
journal = "Journal of Critical Care",
issn = "0883-9441",
publisher = "Saunders",

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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

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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 -