The effect of fluid balance, norepinephrine and blood glucose levels on syndecan-1 level in sepsis patients

Background & objective. Damage to the endothelium glycocalyx layer can cause sepsis. Several diverse factors have been suggested to worsen the damage, such as high mean fluid balance, high norepinephrine doses, high blood glucose levels, and high baseline levels of syndecan-1 level. This study aimed to show that these components are risk factors for aggravated damage to the endothelium glycocalyx layer, as seen by syndecan-1 levels, and also to find the relation between norepinephrine dose and mortality in sepsis patient. Methodology: This observational analytic study was conducted using a prospective, cohort approach on sepsis patients aged between 18 to 65 y, who were treated at our intensive care unit (ICU) from March 2021 to June 2021. A total of 40 subjects were assigned into two groups and monitored for three days. On day 0 and day 3, the levels of syndecan-1 were analyzed. Statistical test analysis used chi square and Mann Whitney tests, followed by a multivariate assessment using the logistic regression test to determine the significance with P < 0.05. The patients were followed till they were discharged from the hospital to determine the mortality rate. Results: Mean fluid balance, mean norepinephrine dose and glucose level had no significant relation with syndecan-1 level (P = 1, P = 0.145, and P = 1, respectively). Meanwhile norepinephrine dose of more than 0.1 μg/kg/min was related significantly with death (P = 0.016). Conclusion. In septic patients, fluid balance, norepinephrine dose and blood glucose do not associate with syndecan-1 level. However, norepinephrine dose relates to mortality significantly.