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首页> 外文期刊>Current opinion in anaesthesiology >The impact of the glycocalyx on microcirculatory oxygen distribution in critical illness.
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The impact of the glycocalyx on microcirculatory oxygen distribution in critical illness.

机译：糖萼对危重疾病中微循环血氧分布的影响。

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PURPOSE OF REVIEW: Main problems of critical illness and sepsis are an altered oxygen distribution and microvascular dysfunction linked to tissue oedema. This review seeks to analyse the role of the endothelial glycocalyx in this context. RECENT FINDINGS: The presence of vascular leakage is typically associated with interstitial oedema, arterial hypotension, hypovolaemia and often a bad outcome in patients with systemic inflammation. Early goal-directed therapy provides significant benefits in severe sepsis and septic shock, but is mostly aimed at improving macrohaemodynamics. Recent data suggest that microcirculation also contributes significantly to the pathophysiology of critical illness. In fact, the endothelial glycocalyx plays a major role in vascular barrier competence. According to experimental evidence, it can easily be degraded in the presence of inflammation, but, theoretically also protected by several measures. Clinical studies revealed a positive correlation of the severity of sepsis and ischaemia with mortality, but also with a deterioration of the endothelial glycocalyx. Future investigation should focus on the preservation of this structure and assess microcirculatory variables to judge the success of cardiocirculatory therapy. SUMMARY: Deterioration of the endothelial glycocalyx initiates a breakdown of the vascular barrier in systemic inflammatory response syndrome and sepsis. Preserving this structure in critical illness might be a future therapeutical goal to improve microcirculatory oxygen distribution.
机译：审查目的：危重病和败血症的主要问题是与组织水肿有关的氧气分布改变和微血管功能障碍。本文旨在分析内皮糖萼在这种情况下的作用。最近的发现：血管渗漏的存在通常与间质性水肿，动脉低血压，低血容量有关，并且在全身性炎症患者中往往是不良的预后。早期的目标导向疗法在严重的败血症和败血性休克中具有明显的益处，但主要目的是改善血液动力学。最近的数据表明，微循环系统也对危重病的病理生理有重要贡献。实际上，内皮糖萼在血管屏障能力中起主要作用。根据实验证据，在发炎的情况下，它很容易降解，但从理论上讲，它也可以通过多种措施加以保护。临床研究显示败血症和局部缺血的严重程度与死亡率呈正相关，但与内皮糖萼的恶化也呈正相关。未来的研究应着眼于这种结构的保存并评估微循环变量，以判断心脏循环疗法的成功。摘要：内皮糖萼的恶化启动了系统性炎症反应综合征和败血症中血管屏障的破坏。在危重病中保留这种结构可能是改善微循环血氧分布的未来治疗目标。

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