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