Preinterventional hydrocortisone sustains the endothelial glycocalyx in cardiac surgery

Clinical Hemorheology and Microcirculation
Florian BrettnerF Weis

Abstract

Patients undergoing cardiac surgery commonly develop systemic inflammation associated with tissue edema, which impairs outcome. One main pathomechanism leading to the edema is the deterioration of the endothelial glycocalyx, a key component of the vascular barrier. In animal models hydrocortisone has proved to be protective for the glycocalyx. This trial evaluates the effect of hydrocortisone on glycocalyx integrity in patients undergoing cardiac surgery with cardiopulmonary bypass. In a prospective, randomized interventional pilot trial, 30 patients received either hydrocortisone (100 mg over 10 min) or placebo (saline control) before surgery. Plasma concentrations of glycocalyx constituents (syndecan-1, heparan sulfate) and various clinical parameters (respiratory and renal function, inflammatory markers, use of vasopressors, length of stay at the intensive care unit) were measured. Primary endpoint was a significant difference of glycocalyx constituents in plasma. Comparisons were made with Friedman's and Wilcoxon tests (paired data), or the Kruskal-Wallis and Mann-Whitney U tests (unpaired data). Holm-Bonferroni method was used for post-hoc corrections. Heparan sulfate and syndecan-1 increased significantly during and after...Continue Reading

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Citations

Feb 5, 2019·Clinical Hemorheology and Microcirculation·Robert G HahnJoachim Zdolsek
Dec 7, 2018·Clinical Hemorheology and Microcirculation·David AstapenkoVladimir Cerny
Feb 18, 2021·Acta Anaesthesiologica Scandinavica·Robert G HahnRandal O Dull
Mar 12, 2021·Frontiers in Immunology·Patricia P WadowskiRenate Koppensteiner

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