title: Trauma and Endothelial Glycocalyx: The Microcirculation Helmet?
abstract: Trauma represents a remarkable social and economical burden, being a leading cause of death and morbidity in the young population. The Endothelial Glycocalyx (EG) is a web of membrane bound to the luminal side of the blood vessels endothelium. Its role includes maintenance of the vascular permeability barrier and mediation of shear response. The contribution of the EG to a number of clinical conditions, sepsis, and ischemia/reperfusion injury among others has been well studied. With this review we initially explore the role of the EG in the microcirculatory dysfunction associated with trauma. Subsequently, we investigate the impact of fluid administration on the EG, including its potential of protecting the microcirculation from the detrimental effects of trauma. Particular emphasis is reserved to the role of inflammatory modulation and sensible fluid resuscitation.
authors.affiliation: *St. Michael Hospital, Toronto, Ontario, Canada †King's College Hospital, London, UK ‡Humber College, Toronto, Ontario, Canada §Scientist in the Keenan Research Centre for Biomedical Science of St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Mazin
authors.initials: M
authors.lastname: Tuma
authors.forename: Sergio
authors.initials: S
authors.lastname: Canestrini
authors.forename: Zeina
authors.initials: Z
authors.lastname: Alwahab
authors.forename: John
authors.initials: J
authors.lastname: Marshall
mesh_terms: D000818:Animals; D002199:Capillary Permeability / Q000502:physiology; D004730:Endothelium, Vascular / Q000378:metabolism / Q000502:physiology; D019276:Glycocalyx / Q000378:metabolism* / Q000502:physiology; D006801:Humans; D008833:Microcirculation / Q000502:physiology*; D014947:Wounds and Injuries / Q000378:metabolism*