Comparison of the Effects of Sevoflurane and Desflurane on Endothelial Glycocalyx
Condition: Endothelial Dysfunction
Study type: Observational [Patient Registry]

Summary: 
      The glycocalyx is a dynamic and complex biochemical structure composed of proteoglycans,
      glycoproteins, and soluble proteins. The glycocalyx interacts with various proteins such as
      albumin and orosomucoid to form a thick surface layer on the vessel surface that is
      physiologically active. This is called the endothelial surface layer. This structure is
      constantly changing with the blood flowing in the vein. The glycocalyx regulates oncotic
      pressure and also prevents leukocyte and platelet adhesion to the endothelium. Endothelial
      cell dysfunction is a valuable marker of increased vascular permeability and impaired
      angiogenesis due to cardiovascular, thoracic, renal, and metabolic diseases.
    

Detailed description: 
      The glycocalyx is a dynamic and complex biochemical structure composed of proteoglycans,
      glycoproteins, and soluble proteins. The glycocalyx interacts with various proteins such as
      albumin and orosomucoid to form a thick surface layer on the vessel surface that is
      physiologically active. This is called the endothelial surface layer. This structure is
      constantly changing with the blood flowing in the vein. The glycocalyx regulates oncotic
      pressure and also prevents leukocyte and platelet adhesion to the endothelium. Endothelial
      cell dysfunction is a valuable marker of increased vascular permeability and impaired
      angiogenesis due to cardiovascular, thoracic, renal, and metabolic diseases.

      Some medical approaches, including anti-thrombin III, nitric oxide, the TNF-α analog
      etanercept, and inhalation agents, can repair or prevent deterioration of the endothelial
      glycocalyx. In a study by Chen et al., it was shown that Sevoflurane has a protective effect
      on syndecan and heparan sulfate, which are located in the glycocalyx structure, thus reducing
      leukocyte and platelet adhesion and protecting the vascular endothelium (8).

      Kim et al. In a study conducted, it was shown that the protective effect of propofol, an
      intravenous anesthetic, on the vascular endothelium was greater than that of sevoflurane In
      our research, no study was found on the effect of another inhalation anesthetic, desflurane,
      on the vascular glycocalyx structure. In this study, we aimed to investigate and compare the
      effects of sevoflurane and desflurane on glycocalyx.
    

Intervention name(s): desflurane anesthesia; sevoflurane anesthesia
Intervention type(s): Diagnostic Test; Diagnostic Test
Intervention description(s): Anesthesia maintenance of the first group will be provided with desflurane, one of the inhalation anesthetics we routinely use. Before and after the operation, blood will be taken from the patients, and the blood will be centrifuged to evaluate the heparan sulfate and syndecan levels.; Anesthesia maintenance of the first group will be provided with sevoflurane, one of the inhalation anesthetics we routinely use. Before and after the operation, blood will be taken from the patients, and the blood will be centrifuged to evaluate the heparan sulfate and syndecan levels.
Intervention MeSH terms: Anesthetics; Sevoflurane; Desflurane
Observational model: Other
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        healthy volunteers