Endothelial function
Responsible for Autoregulation via sensing shear stress
Glycocalyx
responsible for increased permeability in septic shock
not its fault tbh
function
copied from Deranged Physiology
- Forms the interface between the vessel wall and moving blood.
- Acts as the exclusion zone between blood cells and the endothelium
- Acts as a barrier against leakage of fluid, proteins and lipids across the vascular wall.
- Interacts dynamically with blood constituents.
- Acts the "molecular sieve" for plasma proteins, forming the basis of the Starling principle and acting as the origin of the oncotic forces which control the transcapillary movement of water. → THIS is the semi-permeable membrane
- Modulates adhesion of inflammatory cells and platelets to the endothelial surface.
- Functions as a sensor and mechanotransducer of the fluid shear forces to which the endothelium is exposed; thus the glycocalyx mediates shear-stress-dependent nitric oxide production.
- Retains protective enzymes (eg. superoxide dismutase).
- Retains anticoagulation factors, eg:
- Tissue factor inhibitor
- Protein C
- Antithrombin
what damages the glycocalyx?
- any atherosclerotic processes
- inflammation - TNF alpha
- hypervolaemia - ANP
- ischaemic/reperfusion
- sepsis
- trauma
- surgery
which causes the following trouble
- ↑ capillary permeabiity
- hypercoagulability; platelet aggregation
- inflammation