MD, FACS, RVT, CLT
The Glycocalyx: What Is It and Why Is It Important?
Saturday, May 4, 1:30pm – 2:15pm
With the invention of the electron microscope, a new frontier was opened. This powerful tool allowed for the discovery in the 1940’s of a villous-type structure in the endothelium that was named the glycocalyx. The presence and function of the glycocalyx appears to explain the missing part of Starling’s principle that was first proposed more than a century ago. This presentation will describe the glycocalyx and how its function suggests that lymphatic vessels are much more important to the overall fluid balance of the body than previously understood.
- Identify the components of the glycocalyx.
- Explain the function of the glycocalyx in the fluid balance of the body.
Michel C, “Starling: The formulation of his hypothesis of microvascular fluid exchange and its significance after 100 years” Experimental Physiology, 1997: 82, 1-30
Adamson RH, Lenz JF, Weinbaum S, et al; “Oncotic pressures opposing filtration across non-fenestrated rat microvessels” J Physiol, 2004, 557, 889-907
Levick RJ, Michel CC, “Microvascular fluid exchange and the revised Starling prionciple” Cardiovascular Research, 2010, 87, 198-210
Woodcok TE, Woodcock TM; “revised Starling equation and the glycocalyx model of transvascular fluid exchange: an improved paradigm for prescribing intravenous fluid therapy” British Journal of Anesthesia, 2012, 108, 384-394
Crockett ES, “Endothelia glycocalyx and the revised Starling principle” PVRI Chronicle, 2014, 1; 41-46
Zolla V, Nizamutdinova IT, Scharf B, et al. “Aging-related anatomical and biochemical changes in lymphatic collectors impair lymph transport, fluid homeostasis, and pathogen clearance” Aging Cell, 2015, 14, 582-594
Dr. Baltazar is Board Certified in Vascular Surgery. He is a Fellow of the American College of Surgeons and a member of the American College of Phlebology. He is also certified by the American Registry for diagnostic medical sonography as a Registered Vascular Technologist and a Registered Physician in Vascular Interpretation. Recently, Dr. Baltazar obtained his certification as a lymphedema therapist from Klose Training.
Dr. Baltazar is the Medical Director of the newly-created veno-lymphatic service at Houston Methodist Hospital in Houston, Texas.