Rapid Patient-Side Evaluation of Endothelial Glycocalyx Thickness in Healthy Sedated Cats Using GlycoCheck® Software

The endothelial glycocalyx (EG) determines transvascular fluid fluxes, and influences inflammation, coagulation, and capillary blood flow. The GlycoCheck® software calculates EG thickness using sidestream dark field videomicroscopy recordings. This method has not been evaluated for use in cats. The aim of the present study was to evaluate the use of GlycoCheck® for estimating EG thickness in healthy cats, and to investigate the variability of EG thickness in this population. One hundred and one healthy research-purposed cats were included in the study. The cats were sedated, and a handheld videomicroscope, connected to GlycoCheck® software, was used to evaluate the sublingual microvasculature. The parameters measured included perfused boundary region (PBR, an indirect measurement of EG thickness) in vessels between 5 and 25 μm in diameter, valid vessel density, percentage red blood cell filling, and median red blood cell column width. Heart rate, respiratory rate, pulse oximetry and oscillometric blood pressure readings were also recorded. There were 35 neutered male cats, 11 intact males, 38 neutered females, and 17 intact females. The average age was 63 months (range, 11–160 months). Tolerance intervals for PBR (vessel diameter 5–25 μm) were 1.89–3.00 μm (95% CI, lower limit 1.76–2.04, upper limit 2.83–3.13 μm); for valid vessel density were 73.33–333.33 μm/mm2 (95% CI, lower limit 77.00–99.33, upper limit 312.67–350.33 μm/mm2); for percentage red blood cell filling were 59.85–85.07% (95% CI, lower limit 58.97–63.33, upper limit 83.07–88.20 %); and for median red blood cell column width were 5.63–8.59 μm (95% CI, lower limit 5.28–6.07, upper limit 8.14–9.51 μm). There was a negative association between median red blood cell column width and body weight (p = 0.007). The median red blood cell column was significantly wider in intact females when compared to spayed females (p = 0.033). The GlycoCheck® analysis was easily performed in healthy sedated cats. Clinical variables did not have an effect on the EG thickness. These results suggest that this technique could be valuable for evaluation of the EG and microvascular parameters in cats.

[1]  S. Reis,et al.  Noninvasive sublingual microvascular imaging reveals sex‐specific reduction in glycocalyx barrier properties in patients with coronary artery disease , 2020, Physiological Reports.

[2]  D. Backer.  Is microcirculatory assessment ready for regular use in clinical practice , 2019 .

[3]  A. Zwinderman,et al.  Sublingual endothelial glycocalyx and atherosclerosis. A cross-sectional study , 2019, PloS one.

[4]  Eric P. Schmidt,et al.  The glycocalyx: a novel diagnostic and therapeutic target in sepsis , 2019, Critical Care.

[5]  Blutinger.  Abstracts from the International Veterinary Emergency and Critical Care Symposium, the European Veterinary Emergency and Critical Care Annual Congress, and the ACVECC VetCOT Veterinary Trauma & Critical Care Conference 2018 , 2018, Journal of veterinary emergency and critical care.

[6]  H. Pavenstädt,et al.  Bedside analysis of the sublingual microvascular glycocalyx in the emergency room and intensive care unit – the GlycoNurse study , 2018, Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.

[7]  G. Schelling,et al.  The CYCLOCALYX study: Ovulatory cycle affects circulating compartments of the endothelial glycocalyx in blood , 2018, American journal of reproductive immunology.

[8]  S. Giguère,et al.  Comparison of the oral and rectal mucosal and colonic serosal microcirculations of healthy, anesthetized horses. , 2018, Canadian journal of veterinary research = Revue canadienne de recherche veterinaire.

[9]  S. Ostrowski,et al.  Shock induced endotheliopathy (SHINE) in acute critical illness - a unifying pathophysiologic mechanism , 2017, Critical Care.

[10]  Daniel Chappell,et al.  Regulation of blood flow and volume exchange across the microcirculation , 2016, Critical Care.

[11]  V. Clifton,et al.  Videomicroscopy as a tool for investigation of the microcirculation in the newborn , 2016, Physiological reports.

[12]  J. Tarbell,et al.  The glycocalyx and its significance in human medicine , 2016, Journal of internal medicine.

[13]  J. Pittet,et al.  THE GLYCOCALYX AND TRAUMA: A REVIEW , 2015, Shock.

[14]  E. Rudloff,et al.  Feline Circulatory Shock , 2016 .

[15]  D. Gunn-Moore.  August's Consultations in Feline Internal Medicine , 2015 .

[16]  M. Jacob,et al.  Degradation of the endothelial glycocalyx in clinical settings: searching for the sheddases , 2015, British journal of clinical pharmacology.

[17]  E. Cooper,et al.  Assessment of microcirculatory perfusion in healthy anesthetized cats undergoing ovariohysterectomy using sidestream dark field microscopy. , 2015, Journal of veterinary emergency and critical care.

[18]  J. Staessen,et al.  Characteristics and Determinants of the Sublingual Microcirculation in Populations of Different Ethnicity , 2015, Hypertension.

[19]  G. Villa,et al.  Glycocalyx and sepsis-induced alterations in vascular permeability , 2015, Critical Care.

[20]  D. Peeters,et al.  Evaluation of a rapid bedside scoring system for microcirculation videos acquired from dogs. , 2014, Journal of veterinary emergency and critical care.

[21]  R. de Mutsert,et al.  Deeper Penetration of Erythrocytes into the Endothelial Glycocalyx Is Associated with Impaired Microvascular Perfusion , 2014, PloS one.

[22]  J. Vincent,et al.  Pathophysiology of microcirculatory dysfunction and the pathogenesis of septic shock , 2013, Virulence.

[23]  S. Ostrowski,et al.  Endothelial glycocalyx degradation induces endogenous heparinization in patients with severe injury and early traumatic coagulopathy , 2012, The journal of trauma and acute care surgery.

[24]  T. Woodcock,et al.  Revised Starling equation and the glycocalyx model of transvascular fluid exchange: an improved paradigm for prescribing intravenous fluid therapy. , 2012, British journal of anaesthesia.

[25]  L. Rasmussen,et al.  A High Admission Syndecan-1 Level, A Marker of Endothelial Glycocalyx Degradation, Is Associated With Inflammation, Protein C Depletion, Fibrinolysis, and Increased Mortality in Trauma Patients , 2011, Annals of surgery.

[26]  E. Cooper,et al.  Assessment of microcirculatory changes by use of sidestream dark field microscopy during hemorrhagic shock in dogs. , 2011, American journal of veterinary research.

[27]  B. Funke,et al.  Sepsis and major abdominal surgery lead to flaking of the endothelial glycocalix. , 2011, The Journal of surgical research.

[28]  J. Levick,et al.  Microvascular fluid exchange and the revised Starling principle. , 2010, Cardiovascular research.

[29]  M. Weigand,et al.  Sepsis-Induced Degradation of Endothelial Glycocalix , 2010, TheScientificWorldJournal.

[30]  K. Drobatz,et al.  Measurements of microvascular perfusion in healthy anesthetized dogs using orthogonal polarization spectral imaging. , 2009, Journal of veterinary emergency and critical care.

[31]  K. Peter,et al.  Shedding of the Endothelial Glycocalyx in Patients Undergoing Major Vascular Surgery With Global and Regional Ischemia , 2007, Circulation.

[32]  Dick W. Slaaf,et al.  The endothelial glycocalyx: composition, functions, and visualization , 2007, Pflügers Archiv - European Journal of Physiology.

[33]  S. Haskins,et al.  Determination of P50 for feline hemoglobin , 2005 .

[34]  W. Muir,et al.  Absorbance Spectra of Inter‐Species Hemoglobins in the Visible and Near Infrared Regions , 1997 .

[35]  T. Murakami,et al.  Blood and Lymphatic Microvascular Organization of the Digestive Tract , 1992 .

[36]  J. Morrison,et al.  Comparative microvascular anatomy of mammalian ciliary processes. , 1987, Investigative ophthalmology & visual science.

[37]  S. Edelstein,et al.  Cat hemoglobin. pH dependence of cooperativity and ligand binding. , 1974, The Journal of biological chemistry.