Document Detail

The endothelial glycocalyx affords compatibility of Starling's principle and high cardiac interstitial albumin levels.
MedLine Citation:
PMID:  17196565     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To test the role of an oncotic pressure gradient across the endothelial glycocalyx with respect to extravasation of fluid and colloids and development of tissue edema in a whole organ setting. METHODS: We measured filtration in the intact coronary system of isolated guinea pig hearts, comparing colloid-free perfusion and perfusion with 1.67% albumin or 2% hydroxyethylstarch (oncotic pressures 5.30 vs. 11.10 mm Hg, respectively). Heparinase was used to alter the endothelial glycocalyx. RESULTS: Extremely high net organ hydraulic conductivity was obtained with colloid-free perfusion (9.14 microl/min/g tissue). Supplementing perfusate with albumin caused a significant decrease, also vs. hydroxyethylstarch (1.04 vs. 2.67 microl/min/g, p < 0.05). Albumin also lowered edema formation vs. the other perfusion modes (p < 0.05). Stripping the glycocalyx of heparan sulfate reduced the effect of colloids, especially that of albumin. The steady-state concentrations of hydroxyethylstarch and albumin in the mixed interstitial fluid leaving the intact coronary bed averaged about 95% of the intravascular level. Electron and light microscopy indicated that colloid extravasated mainly in the venular sections. CONCLUSION: We propose a low-filtration model for the coronary system with different barrier properties in arteriolar/capillary and venular sections. Arteriolar/capillary: very little fluid and colloid extravasation due to the endothelial surface layer formed by the glycocalyx and albumin plus the endothelial strand barrier; venular: little net extravsation of fluid and colloids despite large pores, because of low hydrostatic and oncotic pressure differences between intra- and extravascular spaces. The latter sites provide physiological access of large solutes (colloids) to the tissue.
Matthias Jacob; Dirk Bruegger; Markus Rehm; Mechthild Stoeckelhuber; Ulrich Welsch; Peter Conzen; Bernhard F Becker
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2006-11-21
Journal Detail:
Title:  Cardiovascular research     Volume:  73     ISSN:  0008-6363     ISO Abbreviation:  Cardiovasc. Res.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-16     Completed Date:  2007-06-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0077427     Medline TA:  Cardiovasc Res     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  575-86     Citation Subset:  IM    
Clinic of Anesthesiology, Ludwig-Maximilians University Munich, Nussbaumstr. 20, D-80336 Munich, Germany.
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MeSH Terms
Albumins / metabolism*,  pharmacology
Biological Transport
Capillary Permeability
Coronary Disease / metabolism*,  pathology
Coronary Vessels / ultrastructure
Edema / metabolism*,  pathology
Electrolytes / pharmacology
Endothelium, Vascular / metabolism*,  ultrastructure
Extracellular Fluid / metabolism*
Exudates and Transudates / metabolism
Glycocalyx / metabolism*,  ultrastructure
Guinea Pigs
Heparin Lyase
Microscopy, Electron
Models, Animal
Starch / pharmacology
Reg. No./Substance:
0/Albumins; 0/Electrolytes; 9005-25-8/Starch; EC Lyase

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