INTRODUCTION: @entity697 ( @entity697 ) and @entity9420 ( @entity9420 ) are standard blood-sparing procedures. However, @entity9420 is associated with hypervolemia, which may cause tissue @entity4 , @entity532 and a prolonged hospital stay. The body reacts to hypervolemia with release of @entity8224 ( @entity8224 ) from the heart. @entity8224 has been shown to deteriorate the endothelial glycocalyx, a vital part of the vascular permeability barrier. The aim of the present study was to evaluate and compare @entity8224 release and damage to the glycocalyx during @entity697 and @entity9420 . METHODS: @entity697 or @entity9420 with 6% hydroxyethyl starch 130/0.4 was administered prior to elective surgery in @entity1 of good cardiopulmonary health (n =9 in each group). We measured concentrations of @entity8224 in plasma and of three main constituent parts of the glycocalyx (hyaluronan, heparan @entity597 and @entity13221 ) in serum before and after @entity697 or @entity9420 . Heparan @entity597 and @entity13221 levels in urine were also determined. RESULTS: In contrast to @entity697 , @entity9420 (20  ml/kg) induced a significant release of @entity8224 (approximately +100%, P <0.05) and increased the serum concentration of two glycocalyx constituents, hyaluronan and @entity13221 (both by about 80%, P <0.05). Elevation of @entity13221 was also detected in the urine of @entity1 undergoing @entity9420 , but no increase was found in @entity1 undergoing @entity697 . Heparan @entity597 levels were not influenced by either procedure. CONCLUSION: These data suggest that hypervolemia increases the release of @entity8224 and causes enhanced shedding of the endothelial glycocalyx. This perturbation must be expected to impair the vascular barrier, implying that @entity9420 may not be as safe as generally assumed and that it should be critically evaluated.

Hypervolemia increases release of XXXX and shedding of the endothelial glycocalyx.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity697 :: ('MESH:D000208', 'Disease') :: ['Acute normovolemic hemodilution', 'ANH'] @entity8224 :: ('4878', 'Gene') :: ['ANP', 'atrial natriuretic peptide'] @entity4 :: ('MESH:D004487', 'Disease') :: ['edema'] @entity9420 :: ('MESH:C536761', 'Disease') :: ['VL', 'volume loading'] @entity532 :: ('MESH:D003925', 'Disease') :: ['cardiopulmonary complications'] @entity13221 :: ('6382', 'Gene') :: ['syndecan 1'] @entity597 :: ('CHEBI:16189', 'Chemical') :: ['sulfate']
@entity8224 :: (4878,Gene) :: ['atrial natriuretic peptide']
