Protective Treatments against Endothelial Glycocalyx Degradation in Surgery: A Systematic Review and Meta-Analysis
The aim was to explore the body of literature focusing on protective treatments against endothelial glycocalyx degradation in surgery. A comprehensive systematic review of relevant articles was conducted across databases. Inclusion criteria: (1) treatments for the protection of the endothelial glyco...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-07-01
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| Series: | Applied Sciences |
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| Online Access: | https://www.mdpi.com/2076-3417/11/15/6994 |
| _version_ | 1797525780545142784 |
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| author | Hasnain Q. R. B. Khan Gwendolen C. Reilly |
| author_facet | Hasnain Q. R. B. Khan Gwendolen C. Reilly |
| author_sort | Hasnain Q. R. B. Khan |
| collection | DOAJ |
| description | The aim was to explore the body of literature focusing on protective treatments against endothelial glycocalyx degradation in surgery. A comprehensive systematic review of relevant articles was conducted across databases. Inclusion criteria: (1) treatments for the protection of the endothelial glycocalyx in surgery; (2) syndecan-1 used as a biomarker for endothelial glycocalyx degradation. Outcomes analysed: (1) mean difference of syndecan-1 (2) correlation between glycocalyx degradation and inflammation; (3) correlation between glycocalyx degradation and extravasation. A meta-analysis was used to present mean differences and 95% confidence intervals. Seven articles with eight randomised controlled trials were included. The greatest change from baseline values in syndecan-1 concentrations was generally from the first timepoint measured post-operatively. Interventions looked to either dampen the inflammatory response or fluid therapy. Methylprednisolone had the highest mean difference in plasma syndecan-1 concentrations. Ulinastatin showed correlations between alleviation of degradation and preserving vascular permeability. In this systematic review of 385 patients, those treated were more likely than those treated with placebo to exhibit less shedding of the endothelial glycocalyx. Methylprednisolone has been shown to specifically target the transient increase of glycocalyx degradation immediately post-operation and has displayed anti-inflammatory effects. We have proposed suggestions for improved uniformity and enhanced confidence for future randomised controlled trials. |
| first_indexed | 2024-03-10T09:18:50Z |
| format | Article |
| id | doaj.art-68f40234ade44111ad68aa864d0dd40e |
| institution | Directory Open Access Journal |
| issn | 2076-3417 |
| language | English |
| last_indexed | 2024-03-10T09:18:50Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Applied Sciences |
| spelling | doaj.art-68f40234ade44111ad68aa864d0dd40e2023-11-22T05:22:45ZengMDPI AGApplied Sciences2076-34172021-07-011115699410.3390/app11156994Protective Treatments against Endothelial Glycocalyx Degradation in Surgery: A Systematic Review and Meta-AnalysisHasnain Q. R. B. Khan0Gwendolen C. Reilly1Academic Unit of Medical Education, Faculty of Medicine, Dentistry and Health, Sheffield Medical School, University of Sheffield, Beech Hill Road, Broomhall, Sheffield S10 2RX, UKDepartment of Material Sciences and Engineering, INSIGNEO Institute for In Silico Medicine, University of Sheffield, Mappin Street, Sheffield S1 3JD, UKThe aim was to explore the body of literature focusing on protective treatments against endothelial glycocalyx degradation in surgery. A comprehensive systematic review of relevant articles was conducted across databases. Inclusion criteria: (1) treatments for the protection of the endothelial glycocalyx in surgery; (2) syndecan-1 used as a biomarker for endothelial glycocalyx degradation. Outcomes analysed: (1) mean difference of syndecan-1 (2) correlation between glycocalyx degradation and inflammation; (3) correlation between glycocalyx degradation and extravasation. A meta-analysis was used to present mean differences and 95% confidence intervals. Seven articles with eight randomised controlled trials were included. The greatest change from baseline values in syndecan-1 concentrations was generally from the first timepoint measured post-operatively. Interventions looked to either dampen the inflammatory response or fluid therapy. Methylprednisolone had the highest mean difference in plasma syndecan-1 concentrations. Ulinastatin showed correlations between alleviation of degradation and preserving vascular permeability. In this systematic review of 385 patients, those treated were more likely than those treated with placebo to exhibit less shedding of the endothelial glycocalyx. Methylprednisolone has been shown to specifically target the transient increase of glycocalyx degradation immediately post-operation and has displayed anti-inflammatory effects. We have proposed suggestions for improved uniformity and enhanced confidence for future randomised controlled trials.https://www.mdpi.com/2076-3417/11/15/6994endothelial glycocalyxinflammatory responsefluid loadingsurgerypost-operativealbumin extravasation |
| spellingShingle | Hasnain Q. R. B. Khan Gwendolen C. Reilly Protective Treatments against Endothelial Glycocalyx Degradation in Surgery: A Systematic Review and Meta-Analysis Applied Sciences endothelial glycocalyx inflammatory response fluid loading surgery post-operative albumin extravasation |
| title | Protective Treatments against Endothelial Glycocalyx Degradation in Surgery: A Systematic Review and Meta-Analysis |
| title_full | Protective Treatments against Endothelial Glycocalyx Degradation in Surgery: A Systematic Review and Meta-Analysis |
| title_fullStr | Protective Treatments against Endothelial Glycocalyx Degradation in Surgery: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Protective Treatments against Endothelial Glycocalyx Degradation in Surgery: A Systematic Review and Meta-Analysis |
| title_short | Protective Treatments against Endothelial Glycocalyx Degradation in Surgery: A Systematic Review and Meta-Analysis |
| title_sort | protective treatments against endothelial glycocalyx degradation in surgery a systematic review and meta analysis |
| topic | endothelial glycocalyx inflammatory response fluid loading surgery post-operative albumin extravasation |
| url | https://www.mdpi.com/2076-3417/11/15/6994 |
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