Table 1.

Consequences of Septic Endothelial Glycocalyx Degradation. Disruption of the endothelial glycocalyx during sepsis creates a vulnerable endothelial layer. This leads to local consequences, ultimately contributing to end organ damage. Once degraded, fragments of the glycocalyx also travel though the blood and become systemic effectors.

Local	Systemic
General	General
Enhanced leukocyte-endothelial interaction → Local Inflammation	Augmenting inflammatory signaling → Systemic inflammation
Platelet adhesion → Development of microthrombi	Binding of coagulation factors → Coagulopathy
Nitric oxide-mediated vasodilation → Dysfunction of vascular tone	Inhibition of antimicrobial peptides → Increased susceptibility to infection
Increased vascular permeability → Tissue edema	Binding histones → Dampened inflammation
Organ Specific	Organ Specific
Lung injury and ARDS	Deposition of pathogenic heparan sulfate in the brain → Cognitive dysfunction
Kidney injury
Gut barrier breakdown
Increased blood brain barrier permeability

Abbreviation: ARDS = Acute Respiratory Distress Syndrome