Table 2.

The endothelial surface layer

A) Functions  • Regulation of vascular permeability  • Mediation of shear stress  • Attenuation of leukocyte and platelet adhesion  • Binding of cytokines/chemokines, hormones, etc.

B) Scenarios of damage  • Ischemia/reperfusion, hypoxia, shock  • Inflammation  • Volume loading  • Chronic heart failure (due to release of natriuretic peptides)  • Atherosclerosis and diabetes  • Radiation (?)

C) Present and potential future strategies of clinical protection  • Plasma albumin in organ transplantation  • Hydrocortisone and mast cell inhibition  • Direct cytokine inhibition  • Antithrombin and protease inhibitors  • Avoidance strategies (antioxidants, normovolemia)  • Supply of “prefabs” (e.g., heparinoids, Danaparoid)  • Anesthetic regimens (e.g., sevoflurane)

Adapted from Becker et al. [28]