Jonathan V Martin1, David M Liberati2, Lawrence N Diebel3. 1. Michael and Marian Ilitch Department of Surgery, Wayne State University, Detroit, MI, USA. Electronic address: jvmartin@med.wayne.edu. 2. Michael and Marian Ilitch Department of Surgery, Wayne State University, Detroit, MI, USA. Electronic address: dliberat@med.wayne.edu. 3. Michael and Marian Ilitch Department of Surgery, Wayne State University, Detroit, MI, USA. Electronic address: ldiebel@med.wayne.edu.
Abstract
BACKGROUND: Geriatric trauma patients have high circulating norepinephrine (NE) levels but attenuated release of epinephrine (Epi) in response to increasing severity of injury. We hypothesized that NE and Epi have different effects on the endothelial and glycocalyx components of the vascular barrier following shock. METHODS: Human umbilical vein endothelial cells (HUVEC) were treated with varying concentrations of NE or Epi and exposed to simulated shock conditions (HR). Relevant biomarkers were sampled to index glycocalyx injury and endothelial cell activation. RESULTS: NE was associated with significantly greater glycocalyx damage and endothelial activation/injury vs. Epi treatment groups. There were minimal changes in PAI-1 with either NE or Epi ± H/R. However NE ± H/R was associated with significantly higher tPA levels. CONCLUSIONS: NE favors a profibrinolytic state. Our study supports investigating liberal use of the anti-fibrinolytic agent tranexamic acid in the severely injured geriatric trauma patient.
BACKGROUND: Geriatric traumapatients have high circulating norepinephrine (NE) levels but attenuated release of epinephrine (Epi) in response to increasing severity of injury. We hypothesized that NE and Epi have different effects on the endothelial and glycocalyx components of the vascular barrier following shock. METHODS:Human umbilical vein endothelial cells (HUVEC) were treated with varying concentrations of NE or Epi and exposed to simulated shock conditions (HR). Relevant biomarkers were sampled to index glycocalyx injury and endothelial cell activation. RESULTS: NE was associated with significantly greater glycocalyx damage and endothelial activation/injury vs. Epi treatment groups. There were minimal changes in PAI-1 with either NE or Epi ± H/R. However NE ± H/R was associated with significantly higher tPA levels. CONCLUSIONS: NE favors a profibrinolytic state. Our study supports investigating liberal use of the anti-fibrinolytic agent tranexamic acid in the severely injured geriatric traumapatient.
Authors: Sharven Taghavi; Sarah Abdullah; Farhana Shaheen; Lauren Mueller; Brennan Gagen; Juan Duchesne; Chad Steele; Derek Pociask; Jay Kolls; Olan Jackson-Weaver Journal: PLoS One Date: 2022-10-19 Impact factor: 3.752
Authors: Andrew B Haymet; Nicole Bartnikowski; Emily S Wood; Michael P Vallely; Angela McBride; Sophie Yacoub; Scott B Biering; Eva Harris; Jacky Y Suen; John F Fraser Journal: Front Cardiovasc Med Date: 2021-04-14