• Crit Care · Sep 2022

    Review

    The glycocalyx as a permeability barrier: basic science and clinical evidence.

    • Randal O Dull and Robert G Hahn.
    • Department of Anesthesiology, University of Arizona College of Medicine, Tucson, AZ, USA.
    • Crit Care. 2022 Sep 12; 26 (1): 273273.

    AbstractPreclinical studies in animals and human clinical trials question whether the endothelial glycocalyx layer is a clinically important permeability barrier. Glycocalyx breakdown products in plasma mostly originate from 99.6-99.8% of the endothelial surface not involved in transendothelial passage of water and proteins. Fragment concentrations correlate poorly with in vivo imaging of glycocalyx thickness, and calculations of expected glycocalyx resistance are incompatible with measured hydraulic conductivity values. Increases in plasma breakdown products in rats did not correlate with vascular permeability. Clinically, three studies in humans show inverse correlations between glycocalyx degradation products and the capillary leakage of albumin and fluid.© 2022. The Author(s).

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