To observe the changes and significance of endothelial glycocalyx during fluid overload therapy.

Fifty-seven patients with fluid overload were enrolled. Arterial blood and urine were collected at 0, 12, 24, 48 and 72 h after enrollment. Enzyme linked immunosorbent assay (ELISA) was used to detect the components of glycocayx, namely hyaluronic acid (HA), Syndecance-1 (Syn-1), acetamide heparin sulfate (HS), and chondroitin sulfate (CS).

The primary outcome turned out that as compared with the baseline, the levels of HA and Syn-1 were respectively (1.6±0.5)vs. (4.6±0.8) μg/ml, (169.1±44.4)vs. (369.8±79.2) μg/ml, P<0.05, while the levels of HS and CS were respectively (436.9±106.2) vs. (437.1±105.7) pg/ml, (7.8±4.2)vs. (8.3±5.3) μg/ml, P>0.05. In the group of 48 h, the clearance capacity was the largest, and the decrease of HA and Syn-1 was the most significant, P<0.05. The plasma concentrations of HA in the non-thoracic surgery subgroup and the thoracic surgery subgroup were [(3.0±1.0) μg/ml and (2.1±0.3) μg/ml respectively, P<0.01]. No significant change was observed either in the four components of urine or in the plasma, urine and liquid waste specimens of continuous renal replacement terapy (CRRT) between CRRT and NCRRT groups (P>0.05).

Fluid overload can increase the levels of endothelial glycocalyx, and excessive liquid clearance can decrease the levels of endothelial glycocalyx and improve the microcirculation.

Endothelial glycocalyx; Fluid overload; Microcirculation