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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Minerva Anestesiologica 2018 Jan 16

DOI: 10.23736/S0375-9393.18.12150-X


lingua: Inglese

The effect of various doses of infusion solutions on the endothelial glycocalyx layer in laparoscopic cholecystectomy patients

Matija BELAVIĆ 1, Vlatka SOTOŠEK TOKMADŽIĆ 2, Elizabeta FIŠIĆ 3, Antonija BROZOVIC KRIJAN 1, Nedjeljko STRIKIĆ 4, 5, Mirjana LONČARIĆ KATUŠIN 1, Josip ŽUNIĆ 1, 5

1 Department of Anaesthesiology, Reanimatology, and Intensive Medicine, Karlovac General Hospital, Karlovac, Croatia; 2 Department of Anaesthesiology, Reanimatology, and Intensive Care, Faculty of Medicine, University of Rijeka, Rijeka, Croatia; 3 Clinical Institute of Laboratory Diagnostics, Rijeka Clinical Hospital Center, Rijeka, Croatia; 4 Department of Abdominal Surgery, Karlovac General Hospital, Karlovac, Croatia; 5 Karlovac University of Applied Sciences, Karlovac, Croatia


BACKGROUND: The endothelial glycocalyx is located on the luminal side of blood vessels and maintains vessel integrity. This study analysed how various dosages of infusion affected the secretion of atrial natriuretic peptide (ANP) and potential glycocalyx damage in patients undergoing laparoscopic cholecystectomy. We hypothesised that the liberal administration of Ringer’s solution during the operation can cause iatrogenic hypervolemia with releasing of ANP and glycocalyx damage.
METHODS: The study included 90 patients with American Society of Anesthesiologists’ (ASA) class I and II, in good cardiopulmonary health, who were assigned to one of three groups: Restrictive group, which received 1 ml/kg/hr intraoperatively and six hours postoperatively; Low liberal group, which received 5 ml/kg/hr of Ringer’s solution intraoperatively and six hours postoperatively and High liberal group, which received 15 ml/kg/hr intraoperatively and 10 ml/kg/hr six hours postoperatively. We measured patients’ concentrations of glycocalyx constituents, ANP, markers of kidney and liver function, Creactive protein (CRP), and albumine at three time points. We also measured noinvasive haemodynamics, the correlation between ANP secretion and the concentration of glycocalyx components.
RESULTS: We found a significantly higher concentrations of hyaluronic acid and syndecan-1 and more ANP secretion in the High liberal group than in the other groups. We also observed a positive correlation between ANP secretion and glycocalyx constituent concentration. Markers of kidney and liver function were normal, suggesting preservation of splanchnic perfusion and global haemodynamics.
CONCLUSIONS: Measuring the endothelial glycocalyx constituents in circulating blood could be a marker of intraoperative volume overload during laparoscopic operations.

KEY WORDS: Atrial natriuretic factor - Cholecystectomy - Laparoscopic - Fluid therapy - Glycocalyx - Heparan sulfate proteoglycans - Hyaluronic acid - Syndecan-1

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Publication History

Article first published online: January 16, 2018
Manuscript accepted: January 10, 2018
Manuscript revised: December 15, 2017
Manuscript received: April 25, 2017

Per citare questo articolo

Belavić M, Sotošek Tokmadžić V, Fišić E, Brozovic Krijan A, Strikić N, Lončarić Katušin M, et al. The effect of various doses of infusion solutions on the endothelial glycocalyx layer in laparoscopic cholecystectomy patients. Minerva Anestesiol 2018 Jan 16. DOI: 10.23736/S0375-9393.18.12150-X

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