ReviewCritical care (London, England)2019
The glycocalyx: a novel diagnostic and therapeutic target in sepsis.
Review in Critical care (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 387 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluation of Presepsin and Syndecan-1 as Biomarkers for Early Diagnosis and Prognosis of Sepsis Following Major Surgeries
Study of Perioperative Plasma Levels of Endothelial Glycocalyx Markers in Patients Undergoing Colon Surgery.
Biological and Immunomodulatory Effect of Hemoadsorption With Macroporous Resin Cartridges in Septic Shock and Refractory Septic Shock Two Parallel Open-label Randomized Pilot Trials.
Who cites it
387 citing papers in PubMed, 4 syntheses or guidelines pooled it, 667 citations in OpenAlex.
- Biomarkers of endothelial glycocalyx dysfunction in pregnancy: a systematic review of clinical relevance and detection techniques.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2026Pooled it
- A Systematic Review of Endothelial Dysfunction in Chronic Venous Disease-Inflammation, Oxidative Stress, and Shear Stress.International journal of molecular sciences · 2025Pooled it
- Therapeutic Role of HAT Therapy in Sepsis: A Systematic Review and Meta-Analysis.Current medicinal chemistry · 2025Pooled it
- Effects of albumin and crystalloid priming strategies on red blood cell transfusions in on-pump cardiac surgery: a network meta-analysis.BMC anesthesiology · 2024Pooled it
- Plasma chondroitin sulfate predicts the effectiveness of fluid resuscitation strategies in patients with sepsis.The Journal of clinical investigation · 2026Trial
- The Effects of Conservative Fluid Management and Active Deresuscitation on Markers of Tissue Perfusion, Kidney Injury, and Vascular Injury in Critically Ill Adults: A Secondary Analysis of the Role of Active Deresuscitation After Resuscitation-2 (RADAR-2) Trial.Critical care explorations · 2026Trial
- Endothelial Glycocalyx Degradation in Sepsis: Analysis of the Crystalloid Liberal or Vasopressors Early Resuscitation in Sepsis (CLOVERS) Trial, a Multicenter, Phase 3, Randomized Trial.Annals of the American Thoracic Society · 2025Trial
- Heparanase inhibition leads to improvement in patients with acute gastrointestinal injuries induced by sepsis.World journal of gastroenterology · 2023Trial
- Continuous renal replacement therapy attenuates endothelial injury biomarkers in pediatric sepsis: a prospective cohort study.Renal failure · 2026Observational
- Combined plasma syndecan-1 and renal resistive index as early predictors of sepsis-associated Acute kidney injury: a prospective observational study.Renal failure · 2026Observational
- Sepsis-associated endothelial dysfunction: clinical phenotypes, biomarkers, bedside evidence, and translational implications.The Journal of clinical investigation · 2026Review
- Pregnancy-related disorders: molecular mechanisms and management.Molecular biomedicine · 2026Review
- Integrated haemodynamic monitoring of fluid responsiveness and fluid tolerance in critical care: from physiology to bedside applications.Journal of clinical monitoring and computing · 2026Review
- Unfractionated Heparin and Low-Molecular-Weight Heparin in Sepsis: Anti-Inflammatory and Anticoagulant Effects Versus No Anticoagulation-A Propensity Score-Matched Analysis.Journal of clinical laboratory analysis · 2026Article
- The NLRP3 inflammasome in physiological and dysfunctional host response in human sepsis and critical illness: a narrative review.Critical care (London, England) · 2026Review
- Precision inflammation targeting via myeloperoxidase mediated antioxidant melanin nanomedicines for chronic inflammation therapy.Nature communications · 2026Article
- Endothelial Collapse as a Convergent Immunovascular Phenotype in Sepsis and Severe Arboviral Disease: The SIMVAC Model.Pathogens (Basel, Switzerland) · 2026Review
- CSA-13 treatment in a murine model of Pseudomonas pneumonia-induced sepsis and its effects on renal injury, inflammation, and glycocalyx derangement.The Journal of antibiotics · 2026Article
- Impact of early albumin therapy on 28-day survival in ICU patients with septic shock concurrent hypoalbuminemia: a retrospective analysis of combined clinical datasets.World journal of emergency medicine · 2026Article
- Endothelial biomarkers predict kidney and cardiovascular outcomes after acute kidney injury.Clinical kidney journal · 2026Article
327 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
The glycocalyx is a gel-like layer covering the luminal surface of vascular endothelial cells. It is comprised of membrane-attached proteoglycans, glycosaminoglycan chains, glycoproteins, and adherent plasma proteins. The glycocalyx maintains homeostasis of the vasculature, including controlling vascular permeability and microvascular tone, preventing microvascular thrombosis, and regulating leukocyte adhesion.During sepsis, the glycocalyx is degraded via inflammatory mechanisms such as metalloproteinases, heparanase, and hyaluronidase. These sheddases are activated by reactive oxygen species and pro-inflammatory cytokines such as tumor necrosis factor alpha and interleukin-1beta. Inflammation-mediated glycocalyx degradation leads to vascular hyper-permeability, unregulated vasodilation, microvessel thrombosis, and augmented leukocyte adhesion. Clinical studies have demonstrated the correlation between blood levels of glycocalyx components with organ dysfunction, severity, and mortality in sepsis.Fluid resuscitation therapy is an essential part of sepsis treatment, but overaggressive fluid therapy practices (leading to hypervolemia) may augment glycocalyx degradation. Conversely, fresh frozen plasma and albumin administration may attenuate glycocalyx degradation. The beneficial and harmful effects of fluid and plasma infusion on glycocalyx integrity in sepsis are not well understood; future studies are warranted.In this review, we first analyze the underlying mechanisms of glycocalyx degradation in sepsis. Second, we demonstrate how the blood and urine levels of glycocalyx components are associated with patient outcomes. Third, we show beneficial and harmful effects of fluid therapy on the glycocalyx status during sepsis. Finally, we address the concept of glycocalyx degradation as a therapeutic target.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.