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Recent advances in the understanding of endothelial barrier function and fluid therapy
  1. Guramrinder Singh Thind1,
  2. Steve Zanders2,
  3. Joanne K Baker3
  1. 1 Internal Medicine, Western Michigan University School of Medicine, Kalamazoo, Michigan, USA
  2. 2 Critical Care Services, Lehigh Valley Hospital-Pocono, East Stroudsburg, Pennsylvania, USA
  3. 3 Osteopathic Internal Medicine, Western Michigan University School of Medicine, Kalamazoo, Michigan, USA
  1. Correspondence to Dr Guramrinder Singh Thind, Internal Medicine, Western Michigan University School of Medicine, Kalamazoo, MI 49008, USA; guramrinder.thind{at}med.wmich.edu

Abstract

Elucidation of the structural basis of endothelial barrier function and the study of transcapillary fluid exchange dynamics are areas of active research. There has been significant enhancement in our understanding of the ultrastructural basis of endothelial barrier function. The role of glycocalyx has received special attention. Experimental evidence has called for a revision in the classic Starling principle of transcapillary exchange. The glycocalyx model provides a potential structural mechanism for the revised Starling principle. This knowledge can provide the framework for understanding the volume expansion effect of fluid therapy and the physiological basis of fluid therapy.

  • dual-pore theory
  • endothelial permeability
  • revised starling principle
  • glycocalyx
  • fluid therapy
  • hyperoncotic colloids

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Footnotes

  • Contributors GST performed the literature review and initial manuscript write-up. JKB and SZ critically reviewed and advised on each draft.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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