Table 3 Summary of findings in included sepsis studies (n = 10)
References | Intervention/exposure | Group size, n | Fluid volume (mL) at t = 24 h | Glycocalyx measure(s) | Summary of study findings |
|---|---|---|---|---|---|
Macdonald et al. [33] | Standard fluid regime | 49 | 3550 (2750,4410)a,c,d | Syn-1, Syn-4, HS, hyaluronan; t = 0 h, t = 3 h, t = 6 h, t = 24 h | No consistent relationship was found between fluid administration and glycocalyx markers. Syn-4 and hyaluronan showed greater or contrasting downward pattern in the restricted fluid group compared to standard. No differences were noted for Syn-1 or HS |
Restricted fluid regime | 46 | 4360 (3350,5252)a,c,d | |||
Ilyina [34] | Crystalloid fluid bolus (7 mL/kg) | 18 | 3560, 1870b | Syn-1, HS; t = 0 h, t = 2 h, t = 24 h | There was no significant change in Syn-1 or HS at any time point after fluid loading |
Total fluid administration | 86 | 4073, 2507a | Syn-1, Syn-4, hyaluronan; t = 0 h, t = 24 h | There was no significant relationship between cumulative fluid administration and glycocalyx markers, adjusted for age, sex, mean arterial pressure, lactate, CCI, SOFA score, infection source, and recruitment site | |
Saoraya [31] | Standard fluid rate (30 mL/kg/h) | 49 | 3758 (1237,4975)b,c,d | Syn-1; t = 0 h, t = 6 h | There was no significant intergroup difference in Syn-1 over time, before and after adjusting for hemodynamic status and vasopressor use. There was no significant intra-group change in Syn-1 during the intervention |
Limited fluid rate (10Â mL/kg/h) | 49 | 2896 (1520,4535)b,c,d | |||
Hippensteel [30] | Total fluid administration | 56 | – | Syn-1, HS; t = 0 h, t = 6 h | Heparan sulfate concentration was significantly associated with cumulative fluid administration, after adjusting for age and sepsis severity (p = 0.047) |
Hippensteel [30] | Total fluid administration | 100 | 1681, 1801a | HS; t = 0 h, t = 24 h | Each 1L of administered fluid over 24 h was associated with a 200 ng/mL increase in heparan sulfate, after adjusting for age and sepsis severity (p = 0.006) |
Inkinen [29] | Total fluid administration | 619 | 5928 (4152,8712)a,c | Syn-1; t = 0 h, t = 24 h, t = 120 h | There was no significant relationship between Syn-1 and tertile of cumulative fluid administration |
Pouska et al. [36] | Fast fluid bolus | 25 | – | PBR; t = 0 h, t = 1 h, t = 2 h | There were no significant intergroup differences at any time point after fluid bolus. No significant temporal change in PBR was observed in the general cohort |
Slow fluid bolus | 9 | – | |||
Smart [35] | 10 ml/kg 0.9% NaCl |  | 2000 (1000, 2500)a,c | Syn-1, hyaluronan; t = 0 h, t = 1 h, t = 3 h, t = 24 h | Significant fold-change in Syn-1 T0 to T1 in isotonic group corresponding with larger fluid volume in this period. No overall difference in biomarkers or fluid volume at 24 h. Low illness severity and majority patients had simple infection not sepsis |
5 ml/kg 3% NaCl |  | 1500 (500–2500)a,c | |||
Smart [28] | Total fluid administration | 86 | 3701 (2225,4750)a,c | Syn-1, Syn-4, hyaluronan; t = 0 h, t = 1–2 h, t = 3–5 h, t = 12–24 h | Each 1L of administered fluid was associated with a 22% increase in hyaluronan at t = 0 h, adjusted for infection severity and cytokine response (p = 0.001). This remained significant at t = 1–2 h and t = 3–5, but not at t = 12–24. No associations were noted for Syn-1 or Syn-4 |
Wu [27] | Total fluid administration | 15 | 1616, 1113b | Syn-1; t = 0 h, t = 3 h, t = 6 h, t = 24 h, t = 48 h | Syn-1 levels were highly correlated with corresponding fluid balance at each of the four time points (p = 0.026) |