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

Research output: Contribution to journalArticle

16 Citations (Scopus)


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
Publication statusPublished - Dec 2017

Fingerprint Dive into the research topics of 'Endothelial glycocalyx biomarkers increase in patients with infection during Emergency Department treatment'. Together they form a unique fingerprint.

Cite this