Perioperative Syndecan-1 Dynamics During Cardiac Surgery: Associations with Operative Factors and Patient Characteristics.
Aortic cross-clamp time, not total bypass time, weakly linked to glycocalyx shedding
Perioperative Syndecan-1 Dynamics During Cardiac Surgery: Associations with Operative Factors and Patient Characteristics.
Cardiac surgery with cardiopulmonary bypass (cardiopulmonary bypass) is associated with endothelial glycocalyx injury and perioperative endothelial dysfunction.
The aim of this study was to evaluate perioperative Syndecan-1 dynamics during coronary artery bypass grafting (coronary artery bypass grafting) with cardiopulmonary bypass and to assess associations with ischemia-reperfusion exposure and patient characteristics.
This prospective observational study included 147 patients undergoing elective coronary artery bypass grafting with cardiopulmonary bypass.
longer aortic clamp time tracked with modestly higher shedding, a weak link
Syndecan-1 concentrations changed significantly over time ( p < 0.001), increasing from a baseline median of 49.74 ng/mL to a peak of 147.78 ng/mL at ICU admission, followed by a partial decline to 65.26 ng/mL at 24 h.
No significant associations were observed between cardiopulmonary bypass duration and Syndecan-1 concentrations in univariable analyses.
In the mixed-effects model, a significant non-linear temporal pattern of Syndecan-1 concentrations was observed (both linear and quadratic time terms, p < 0.001).
Syndecan-1 concentrations increase significantly during cardiac surgery with cardiopulmonary bypass, peaking at ICU admission and partially declining within 24 h.
Aortic cross-clamping duration, but not total cardiopulmonary bypass duration, showed weak associations with glycocalyx shedding. Male sex was independently associated with higher Syndecan-1 concentrations.
These findings support ischemia-reperfusion injury as an important contributor to endothelial glycocalyx shedding during cardiac surgery.