The concept of the glycocalyx - Facts that influence perioperative fluid management

Perioperative infusion therapy is an essential component of anesthesia and perioperative medical therapy. In recent years, growing knowledge about the presence and the real dimension of the endothelial glycocalyx has revolutionized the understanding of the vascular endothelial barrier. Apart from the correct composition of the various body compartments and actual fluid losses during surgical interventions, factors that influence the integrity of the glycocalyx are in the focus of experimental science and clinical medicine. Knowledge about the disturbance of the glycocalyx and especially the consequences of glycocalyx shedding should find its way into the treatment during the perioperative period. Recent findings have led to a perioperative fluid and volume therapy concept that is based on pathophysiological changes in the human body. (C) 2012 Elsevier Ltd. All rights reserved.