• Mariana Vigiola Cruz, Bonnie C Carney, Jenna N Luker, Kyle W Monger, Juan Sebastian Vazquez, Lauren T Moffatt, Laura S Johnson, and Jeffrey W Shupp.
• Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC; The Burn Center, Department of Surgery, MedStar Washington Hospital Center, Washington, DC; Department of Surgery, MedStar Georgetown University Hospital, Washington, DC.
• J. Surg. Res. 2019 Jan 1; 233: 459-466.

BackgroundA complex inflammatory response mediates the systemic effects of burn shock. Disruption of the endothelial glycocalyx causes shedding of structural glycoproteins, primarily syndecan-1 (SDC-1), leading to endothelial dysfunction. These effects may be mitigated by resuscitative interventions.Materials And MethodsSprague-Dawley rats were used to create small, medium, and large burns and uninjured controls. Three different intravenous resuscitation protocols were applied within each group: Lactated Ringer's (LR) alone, LR plus fresh frozen plasma (FFP), or LR plus albumin. Blood was serially collected, and plasma SDC-1 was quantified with enzyme-linked immunosorbent assay. In one cohort, Evan's Blue Dye (EBD) was administered and quantified in lung by spectrophotometry as a functional assay of vascular permeability. In a second cohort, intact SCD-1 was quantified by immunohistochemistry in lung tissue. Statistical analysis employed two-way analysis of variance with multiple comparisons and Student's t-test.ResultsEBD extraction from lung was significantly greater with higher injury severity versus controls. Extraction decreased significantly in large-burn animals with addition of FFP to LR versus LR-only; addition of albumin to LR did not decrease EBD extraction. Plasma SCD-1 increased in injured animals compared with controls, and changes correlated with injury severity in all resuscitation groups (significance, P < 0.05). Lung SCD-1 staining reflected the results in the EBD assay.ConclusionsAddition of FFP, not of albumin, to post-burn resuscitation diminishes vascular leakage associated with large burns. Addition of colloid does not affect SDC-1 shedding as measured in plasma. Ongoing work will further define pathophysiologic mechanisms and potential therapeutic interventions to mitigate injury and promote repair of the endothelial glycocalyx.Copyright © 2018 Elsevier Inc. All rights reserved.

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