Changes of glycocalyx thickness during experimental model of cardiac arrest in pigs by using Perfused Boundary Region 

Astapenko D., Skulec R., Cerna Parizkova R., Lehmann Ch., Hovanec T., Mlynkova T., Bilska M., Dudakova J. and Cerny V.

Background and Goal of study: Glycocalyx plays key role in maintaining vascular integrity, perturbation of the endothelial glycocalyx in patients after cardiac arrest has been described by measuring syndecan-1 and heparan sulphate levels [1]. Non-invasive method of evaluating glycocalyx thickness by using Perfused Boundary Region (PBR) has been introduced just recently [2]. The aim of the study was to evaluate changes in PBR on porcine model of cardiac arrest in order to assess the usefulness of PBR as an indicator of glycocalyx damage. 

Material and Methods: Cardiac arrest was introduced by intracardiac electrode triggering ventricular fibrillation and treated by defibrilation after 15 minutes in accordance with 2015 ERC guidelines. Sublingual microcirculation was measured and PBR computed automatically with specialized software in three timepoints: at baseline (PBR_B), after return of spontaneous circulation (PBR_ROSC) and 20 minutes after ROSC (PBR_ROSC_20). 

Results and Discussion: PBR data was obtained from 11 pigs. There was insignificant increase of PBR after ROSC (p = 0.26) (figure 1). The PBR_B was 2,129 (± 0,21), PBR_ROSC was 2.206 (± 0,27) and PBR_ROSC_20 was 2,18 (± 0,19), data showed as mean and standard deviation.

Conclusions: Our data demonstrate insignificant increase of PBR after cardiac arrest. The value of PBR as aindicator of glycocalyx shedding requires further study before introducing this parameter as a routine non-invasive tool in pig model of glycocalyx damage. 

Acknowledgements: supported by AZVCR 9307

References:
[1] Grundmann S, Finka K, Rabadzhieva L, et al. Resuscitation. 2012; 83: 715-720 
[2] Lee DH, Dane MJ, van der Berg BM, et al. PloS One. 2014; 9(5): e96477
 
Figure 1: Perfused Boundary Region in sublingual microcirculation in pigs. Baseline (PBR_B), after return of spontaneous circulation (PBR_ROSC) and 20 minutes arter ROSC (PBR_ROSC_20).

Perfused Boundary Region remains stable after short time experimental cardiac arrest in pigs