From Suzanne Gorenfeld: Dear Mr. Fritsma, Are there currently in use any tests to monitor endothelial barrier function during and immediately after surgery? Thank you for your very informative site. Kind regards, Suzanne.
Hello, Suzanne, and thank you for your question. This is new territory for me, so I will be looking for help from some of our participants. Meanwhile endothelial barrier dysfunction appears to be an active area of research, given there are over 10,000 relevant publications. Check out Koning NJ, Overmars MA, van den Brom CE, et al. Endothelial hyperpermeability after cardiac surgery with cardiopulmonary bypass as assessed using an in vitro bioassay for endothelial barrier function. Br J Anaesth. 2016;116:223–32. This Amsterdam group measured plasma P-selectin, vascular cell adhesion molecule-1 and von Willebrand factor and angiopoietin-2 to angiopoietin-1 ratios as markers for endothelial barrier function subsequent to cardiopulmonary bypass. It appears endothelial barrier dysfunction is most often measured with an ultrasound technique, flow-mediated dilation as described in Peretz A, Leotta DF, Sullivan JH, et al. Flow mediated dilation of the brachial artery: an investigation of methods requiring further standardization. BMC Cardiovasc Disord. 2007;7:11. It appears there is no current approved clinical laboratory test for this Watch here for additional comments.
Recent papers suggested that
Endothelial Layer Barrier Dysfunction
Recent papers suggested that changes in endothelial barrier function and permeability was associated with plasma syndecan-1 level:
Endothelial glycocalyx shedding and vascular permeability in severely injured trauma patients.
Plasma syndecan-1 and heparan sulfate correlate with microvascular glycocalyx degradation in hemorrhaged rats after different resuscitation fluids:
Syndecan-1 improves severe acute kidney injury prediction after pediatric cardiac surgery: