Fig. 1.

Hemorrhagic Shock and Trauma Induce Endothelial Glycocalyx Shedding and Vascular Permeability. This figure depicts longitudinal cross sections of a blood vessel. The top image corresponds to the resting endothelium with the endothelial glycocalyx fully intact. After hemorrhagic shock and trauma, the vasculoprotective endothelial glycocalyx is shed, and tight junctions and adherens junctions are lost. Gaps form between endothelial cells that lead to extravasation of proteins, fluid, and inflammatory cells. Resuscitation with plasma products restores and preserves the endothelial glycocalyx and vascular barrier function.