• Osama Abou-Arab, Saïd Kamel, Christophe Beyls, Pierre Huette, Stéphane Bar, Emmanuel Lorne, Antoine Galmiche, and Pierre-Grégoire Guinot.
• Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France; MP3CV, EA7517, CURS, Jules Verne University of Picardie, Amiens, France.
• J. Cardiothorac. Vasc. Anesth. 2020 Apr 1; 34 (4): 900-905.

ObjectiveTo assess endothelial glycocalyx (EG) alteration in vasoplegic syndrome after cardiac surgery with cardiopulmonary bypass.DesignProspective analysis SETTING: Single university hospitals.ParticipantsPatients undergoing elective cardiac surgery under cardiopulmonary bypass.InterventionsObservational study METHODS: Heparan sulfate and syndecan-1 levels were assessed in plasma before surgery, on intensive care unit admission, and on the first postoperative day. The primary outcome was comparisons of heparan sulfate and syndecan-1 levels in patients with and without vasoplegic syndrome.ResultsA total of 46 patients were analyzed. Only syndecan-1 was modified by cardiac surgery (p < 0.05). Plasma syndecan-1 levels were lower in patients with vasoplegic syndrome at the 3 time-points and were associated with the cumulative norepinephrine dose. Baseline plasma syndecan-1 predicted the development of vasoplegic syndrome with an area under the curve of 0.7 (confidence interval 95%: 0.51-0.85, p = 0.045). Heparan sulfate levels were not modified by cardiac surgery.ConclusionPatients with vasoplegic syndrome after cardiac surgery present a different pattern of EG components. Lower syndecan-1 levels were associated with vasoplegic syndrome. These preliminary results suggest a specific phenotype that may reflect endothelial activation leading to alteration of the EG.Copyright © 2019 Elsevier Inc. All rights reserved.

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