Vessel injury and capillary leak.

Rhonda S. Fishel, Chandrakanth Are, Adrian Barbul

Research output: Contribution to journalReview article

53 Citations (Scopus)

Abstract

OBJECTIVE: To understand the mechanism of pathologic capillary leak in the critically ill patient. DESIGN: Review of normal and altered physiology of the microvasculature. Review of recent literature describing pathogenesis, mediators, and interventions influencing capillary leak and microvascular repair. SETTING: In vitro and in vivo studies, the latter including animal and human subjects. MEASUREMENTS AND MAIN RESULTS: Capillary leak with resultant edema develops in the critical care setting on the basis of perturbations in Starling's equation, primarily as a result of increased capillary permeability to larger molecules. This process is most likely fueled by inflammatory mediators or mechanical stress. Attempts to prevent or treat this process remain largely unsuccessful; resuscitation is more often symptomatic than therapeutic. Models of microvascular repair focus on discrete injury and may not be applicable to the recovery of capillary damage secondary to a systemic leak CONCLUSIONS: Our understanding of capillary leak syndrome remains fragmented and weighted toward specific mediators contributing to the leak. The implications of extensive edema and the mechanism by which it resolves continue to be the subject of speculation rather than study.

Original languageEnglish (US)
JournalCritical care medicine
Volume31
Issue number8 Suppl
StatePublished - Jan 1 2003
Externally publishedYes

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Wounds and Injuries
Edema
Capillary Leak Syndrome
Starlings
Mechanical Stress
Capillary Permeability
Critical Care
Microvessels
Critical Illness
Resuscitation
Therapeutics
In Vitro Techniques

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Fishel, R. S., Are, C., & Barbul, A. (2003). Vessel injury and capillary leak. Critical care medicine, 31(8 Suppl).

Vessel injury and capillary leak. / Fishel, Rhonda S.; Are, Chandrakanth; Barbul, Adrian.

In: Critical care medicine, Vol. 31, No. 8 Suppl, 01.01.2003.

Research output: Contribution to journalReview article

Fishel, RS, Are, C & Barbul, A 2003, 'Vessel injury and capillary leak.', Critical care medicine, vol. 31, no. 8 Suppl.
Fishel RS, Are C, Barbul A. Vessel injury and capillary leak. Critical care medicine. 2003 Jan 1;31(8 Suppl).
Fishel, Rhonda S. ; Are, Chandrakanth ; Barbul, Adrian. / Vessel injury and capillary leak. In: Critical care medicine. 2003 ; Vol. 31, No. 8 Suppl.
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