Vascular leakage during circulatory failure: physiopathology, impact and treatments
Abstract Vascular leakage has emerged as a major factor during circulatory failure. Triggered by the inflammatory process following the recognition of both pathogen-associated molecular patterns (PAMPs) and damage-associated molecular patterns (DAMPs), it worsens circulatory failure through the hypo...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2025-06-01
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| Series: | Annals of Intensive Care |
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| Online Access: | https://doi.org/10.1186/s13613-025-01474-8 |
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| author | Jérémie Joffre Peter Radermacher Hatem Kallel Iris Marangon Alexandre Rutault Yaël Levy Alexandre Gaudet Benjamine Sarton Louis Kreitmann Lucillia Bezu Meryl Vedrenne Thomas Maldiney Youenn Jouan Sarah Benghanem Laure Stiel Stéphane Germain Nicolas Bréchot For the ‘commission recherche translationnelle de la société de réanimation de langue française’ |
| author_facet | Jérémie Joffre Peter Radermacher Hatem Kallel Iris Marangon Alexandre Rutault Yaël Levy Alexandre Gaudet Benjamine Sarton Louis Kreitmann Lucillia Bezu Meryl Vedrenne Thomas Maldiney Youenn Jouan Sarah Benghanem Laure Stiel Stéphane Germain Nicolas Bréchot For the ‘commission recherche translationnelle de la société de réanimation de langue française’ |
| author_sort | Jérémie Joffre |
| collection | DOAJ |
| description | Abstract Vascular leakage has emerged as a major factor during circulatory failure. Triggered by the inflammatory process following the recognition of both pathogen-associated molecular patterns (PAMPs) and damage-associated molecular patterns (DAMPs), it worsens circulatory failure through the hypovolemia it induces. It may also crucially participate in secondary microcirculation disorders and organ dysfunctions, due to interstitial edema resulting from extravascular fluid accumulation. Accordingly, fluid balance, i.e., the difference between fluid intake and output, is directly related with outcomes during the different types of shock. Moreover, controlling vascular leakage had beneficial effects in various animal models of circulatory failure. However, despite promising preclinical findings, no routine drug is currently available to control vascular leakage in humans. This review depicts the mechanisms involved in the maintenance of a quiescent endothelium and those implicated in the destabilization of its barrier function in various forms of shocks. It further describes available tools to explore vascular leakage and the most advanced treatments under development. |
| format | Article |
| id | doaj-art-96aa4a4e2a42460ea9446fb5db02e7aa |
| institution | Kabale University |
| issn | 2110-5820 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Intensive Care |
| spelling | doaj-art-96aa4a4e2a42460ea9446fb5db02e7aa2025-08-20T03:26:43ZengSpringerOpenAnnals of Intensive Care2110-58202025-06-0115111310.1186/s13613-025-01474-8Vascular leakage during circulatory failure: physiopathology, impact and treatmentsJérémie Joffre0Peter Radermacher1Hatem Kallel2Iris Marangon3Alexandre Rutault4Yaël Levy5Alexandre Gaudet6Benjamine Sarton7Louis Kreitmann8Lucillia Bezu9Meryl Vedrenne10Thomas Maldiney11Youenn Jouan12Sarah Benghanem13Laure Stiel14Stéphane Germain15Nicolas Bréchot16For the ‘commission recherche translationnelle de la société de réanimation de langue française’Service de Réanimation Médicale, Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP)Institute for Anesthesiological Pathophysiology and Process Engineering, Ulm UniversityService de Réanimation, Centre Hospitalier de CayenneCenter for Interdisciplinary Research in Biology, Collège de France, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale (INSERM), Université PSLCenter for Interdisciplinary Research in Biology, Collège de France, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale (INSERM), Université PSLPediatric and Neonatal Intensive Care Unit, Armand-Trousseau Hospital, APHPDepartment of Intensive Care Medicine, Critical Care Center, CHU Lille, Univ. LilleService de Réanimation Polyvalente Purpan, Centre Hospitalier Universitaire de ToulouseCentre for Antimicrobial Optimisation, Department of Infectious Disease, Faculty of Medicine, Imperial College LondonDépartement d’Anesthésie, Chirurgie, Interventionnel et Service de RéanimationService de Réanimation Médicochirurgicale Pédiatrique, CHU Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP)Department of Intensive Care Medicine, William Morey General HospitalService de Médecine Intensive Réanimation, CHRU ToursService de Médecine Intensive Réanimation, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP)Department of Intensive Care Medicine, Groupe Hospitalier de la Région Mulhouse Sud AlsaceCenter for Interdisciplinary Research in Biology, Collège de France, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale (INSERM), Université PSLCenter for Interdisciplinary Research in Biology, Collège de France, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale (INSERM), Université PSLAbstract Vascular leakage has emerged as a major factor during circulatory failure. Triggered by the inflammatory process following the recognition of both pathogen-associated molecular patterns (PAMPs) and damage-associated molecular patterns (DAMPs), it worsens circulatory failure through the hypovolemia it induces. It may also crucially participate in secondary microcirculation disorders and organ dysfunctions, due to interstitial edema resulting from extravascular fluid accumulation. Accordingly, fluid balance, i.e., the difference between fluid intake and output, is directly related with outcomes during the different types of shock. Moreover, controlling vascular leakage had beneficial effects in various animal models of circulatory failure. However, despite promising preclinical findings, no routine drug is currently available to control vascular leakage in humans. This review depicts the mechanisms involved in the maintenance of a quiescent endothelium and those implicated in the destabilization of its barrier function in various forms of shocks. It further describes available tools to explore vascular leakage and the most advanced treatments under development.https://doi.org/10.1186/s13613-025-01474-8Vascular leakageShockCirculatory failureSystemic inflammationReviewEndothelium |
| spellingShingle | Jérémie Joffre Peter Radermacher Hatem Kallel Iris Marangon Alexandre Rutault Yaël Levy Alexandre Gaudet Benjamine Sarton Louis Kreitmann Lucillia Bezu Meryl Vedrenne Thomas Maldiney Youenn Jouan Sarah Benghanem Laure Stiel Stéphane Germain Nicolas Bréchot For the ‘commission recherche translationnelle de la société de réanimation de langue française’ Vascular leakage during circulatory failure: physiopathology, impact and treatments Annals of Intensive Care Vascular leakage Shock Circulatory failure Systemic inflammation Review Endothelium |
| title | Vascular leakage during circulatory failure: physiopathology, impact and treatments |
| title_full | Vascular leakage during circulatory failure: physiopathology, impact and treatments |
| title_fullStr | Vascular leakage during circulatory failure: physiopathology, impact and treatments |
| title_full_unstemmed | Vascular leakage during circulatory failure: physiopathology, impact and treatments |
| title_short | Vascular leakage during circulatory failure: physiopathology, impact and treatments |
| title_sort | vascular leakage during circulatory failure physiopathology impact and treatments |
| topic | Vascular leakage Shock Circulatory failure Systemic inflammation Review Endothelium |
| url | https://doi.org/10.1186/s13613-025-01474-8 |
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