Targeting repair of the vascular endothelium and glycocalyx after traumatic injury with plasma and platelet resuscitation.

血浆和血小板复苏创伤后血管内皮和糖萼的靶向修复。

• 发表时间: Jun 2022
• 来源期刊: Matrix Biol Plus
• DOI: 10.1016/j.mbplus.2022.100107
• PMID: 35392184
• 文章类型: Journal Article
• 作者列表: Barry M,Pati S,Barry M,Pati S

关键词: EOT, Endotheliopathy of trauma; Endothelial glycocalyx; FFP, Fresh frozen plasma; Hemorrhagic shock; Plasma; Platelets; TIC, Trauma-induced coagulopathy; Trauma; Vascular permeability; EOT, Endotheliopathy of trauma; Endothelial glycocalyx; FFP, Fresh frozen plasma; Hemorrhagic shock; Plasma; Platelets; TIC, Trauma-induced coagulopathy; Trauma; Vascular permeability

Abstract

Severely injured patients with hemorrhagic shock can develop endothelial dysfunction, systemic inflammation, and coagulation disturbances collectively known as the endotheliopathy of trauma (EOT). Shedding of the endothelial glycocalyx occurs early after injury, contributes to breakdown of the vascular barrier, and plays a critical role in the pathogenesis of multiple organ dysfunction, leading to poor outcomes in trauma patients. In this review we discuss (i) the pathophysiology of endothelial glycocalyx and vascular barrier breakdown following hemorrhagic shock and trauma, and (ii) the role of plasma and platelet transfusion in maintaining the glycocalyx and vascular endothelial integrity.

摘要

严重受伤的失血性休克患者可出现内皮功能障碍，全身性炎症,和凝血障碍统称为创伤内皮病（EOT）。损伤后早期发生内皮糖萼脱落，有助于血管屏障的破坏，并在多器官功能障碍的发病机制中起关键作用，导致创伤患者的不良预后。在这篇综述中，我们讨论了（i）出血性休克和创伤后内皮糖萼和血管屏障破坏的病理生理学，（ii）血浆和血小板输注在维持糖萼和血管内皮完整性中的作用。