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Microvasc Res ; 154: 104683, 2024 07.
Artigo em Inglês | MEDLINE | ID: mdl-38522507

RESUMO

BACKGROUND: Microvascular dysfunction plays a central role in organ dysfunction during septic shock. Endothelial glycocalyx (eGC) damage could contribute to impaired microcirculation. The aim was to assess whether several eGC-damaged biomarkers are associated with microvascular dysfunction in resuscitated septic shock patients. METHODS: This cross-sectional study included resuscitated septic shock patients (N = 31), and a group of healthy individuals (N = 20). The eGC damage biomarkers measured were syndecan-1 (SDC-1), soluble CD44 (CD44s), hyaluronic acid (HYAL) in blood sample; sulfated glycosaminoglycans (GAGs) in urine sample; and thrombomodulin (TBML) in blood sample as biomarker of endothelial cell damage. Microcirculation was assessed through sublingual videocapillaroscopy using the GlycoCheck™, which estimated the perfused vascular density (PVD); the perfused boundary region (PBR), an inverse parameter of the eGC thickness; and the microvascular health score (MVHS). We defined a low MVHS (<50th percentile in septic patients) as a surrogate for more impaired microvascular function. RESULTS: The SDC-1, CD44s, TBML and GAGs levels were correlated with impaired microvascular parameters (PVD of vessels with diameter < 10 µm, MVHS and flow-adjusted PBR); p < 0.05 for all comparisons, except for GAGs and flow-adjusted PBR. The SDC-1 [78 ng/mL (interquartile range (IQR) 45-336) vs. 48 ng/mL (IQR 9-85); p = 0.052], CD44s [796ρg/mL (IQR 512-1995) vs. 526ρg/mL (IQR 287-750); p = 0.036], TBML [734ρg/mL (IQR 237-2396) vs. 95ρg/mL (IQR 63-475); p = 0.012] and GAGs levels [0.42 ρg/mg (IQR 0.04-1.40) vs. 0.07 ρg/mg (IQR 0.02-0.20); p = 0.024]; were higher in septic patients with more impaired sublingual microvascular function (low MVHS vs. high MVHS). CONCLUSION: SDC-1, CD44s, TBML and GAGs levels were associated with impaired microvascular function in resuscitated septic shock patients.


Assuntos
Biomarcadores , Glicocálix , Receptores de Hialuronatos , Ácido Hialurônico , Microcirculação , Choque Séptico , Sindecana-1 , Trombomodulina , Humanos , Glicocálix/metabolismo , Choque Séptico/fisiopatologia , Choque Séptico/sangue , Masculino , Feminino , Pessoa de Meia-Idade , Biomarcadores/sangue , Sindecana-1/sangue , Estudos Transversais , Receptores de Hialuronatos/metabolismo , Idoso , Trombomodulina/sangue , Ácido Hialurônico/sangue , Estudos de Casos e Controles , Ressuscitação , Glicosaminoglicanos , Células Endoteliais/metabolismo , Células Endoteliais/patologia , Angioscopia Microscópica , Microvasos/fisiopatologia , Microvasos/patologia , Adulto , Densidade Microvascular , Soalho Bucal/irrigação sanguínea
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