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Journal article
Effect of intravenous fluid volume on biomarkers of endothelial glycocalyx shedding and inflammation during initial resuscitation of sepsis
Intensive care medicine experimental, Vol.11(1), Art. 21
2023
PMID: 37062769
Abstract
Purpose
To investigate the effect of IV fluid resuscitation on endothelial glycocalyx (EG) shedding and activation of the vascular endothelium and inflammation.
Materials and methods
A planned biomarker sub-study of the REFRESH trial in which emergency department (ED) patients) with suspected sepsis and hypotension were randomised to a restricted fluid/early vasopressor regimen or IV fluid resuscitation with later vasopressors if required (usual care). Blood samples were collected at randomisation (T0) and at 3 h (T3), 6 h (T6)- and 24 h (T24) for measurement of a range of biomarkers if EG shedding, endothelial cell activation and inflammation.
Results
Blood samples were obtained in 95 of 99 enrolled patients (46 usual care, 49 restricted fluid). Differences in the change in biomarker over time between the groups were observed for Hyaluronan (2.2-fold from T3 to T24, p = 0.03), SYN-4 (1.5-fold from T3 to T24, P = 0.01) and IL-6 (2.5-fold from T0 to T3, p = 0.03). No difference over time was observed between groups for the other biomarkers.
Conclusions
A consistent signal across a range of biomarkers of EG shedding or of endothelial activation or inflammation was not demonstrated. This could be explained by pre-existing EG shedding or overlap between the fluid volumes administered in the two groups in this clinical trial.
Trial registration Australia New Zealand Clinical Trials Registry ACTRN126160000006448 Registered 12 January 2016.
Details
- Title
- Effect of intravenous fluid volume on biomarkers of endothelial glycocalyx shedding and inflammation during initial resuscitation of sepsis
- Authors/Creators
- Stephen Macdonald - Royal Perth HospitalErika Bosio - Harry Perkins Institute of Medical ResearchGerben Keijzers - Gold Coast HospitalSally Burrows - Research Foundation, Royal Perth Hospital, Perth, WA, AustraliaMoira Hibbs - Royal Perth HospitalHelen O'Donoghue - Royal Perth HospitalDavid Taylor - Austin HealthAshes Mukherjee - Emergency Department, Armadale Health Service, Perth, WA, AustraliaFrances Kinnear - The University of QueenslandLisa Smart - School of Science, Health Engineering and Education, Murdoch University, Perth, WA, AustraliaJuan-Carlos Ascencio-Lane - Royal Hobart HospitalEdward Litton - Fiona Stanley HospitalJohn Fraser - Prince Charles HospitalNathan I Shapiro - Beth Israel Deaconess Medical CenterGlenn Arendts - The University of Western AustraliaDaniel Fatovich - Emergency Department, Royal Perth Hospital, Perth, WA, AustraliaREFRESH Trial Investigators
- Publication Details
- Intensive care medicine experimental, Vol.11(1), Art. 21
- Publisher
- Springer OPEN
- Identifiers
- 991005572570107891
- Copyright
- © 2023 The Author(s).
- Murdoch Affiliation
- Murdoch University; School of Veterinary Medicine
- Language
- English
- Resource Type
- Journal article
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