T. Annecke, D. Chappell, C. Chen, M. Jacob, U. Welsch, C. P

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Sevoflurane preserves the endothelial glycocalyx against ischaemia–reperfusion injury T. Annecke, D. Chappell, C. Chen, M. Jacob, U. Welsch, C.P. Sommerhoff, M. Rehm, P.F. Conzen, B.F. Becker British Journal of Anaesthesia Volume 104, Issue 4, Pages 414-421 (April 2010) DOI: 10.1093/bja/aeq019 Copyright © 2010 The Author(s) Terms and Conditions

Fig 1 Coronary flow compared with the individual basal value during the experimental course. Data given as median and IQR (T-bars), n=7 each. *P<0.05 vs baseline; #P<0.05 C vs A, B, D, E, and F. British Journal of Anaesthesia 2010 104, 414-421DOI: (10.1093/bja/aeq019) Copyright © 2010 The Author(s) Terms and Conditions

Fig 2 Net fluid filtration expressed as transudate/effluent ratio established throughout the first 20 min of reperfusion or corresponding time (controls A and B). Data given as median, IQR (boxes) and full range (T-bars), n=7 each. The dashed line represents the median basal ratio for all hearts (4.4%; n=42). *P<0.05 Group C reperfusion vs Group C baseline. British Journal of Anaesthesia 2010 104, 414-421DOI: (10.1093/bja/aeq019) Copyright © 2010 The Author(s) Terms and Conditions

Fig 3 Light microscopy of exemplary hearts after immunohistochemical staining of heparan sulphate and syndecan-1. (a) (magnification ×1000) and (d) (magnification ×300) represent hearts without ischaemia and an intact glycocalyx. Loss of staining is evident in (b) (magnification ×1000) and (e) (magnification ×600), indicating destruction of the endothelial glycocalyx after 20 min ischaemia and reperfusion. In (c) (magnification ×600) and (f) (magnification ×300) glycocalyx staining is still present after ischaemia and reperfusion (20 min) with sevoflurane pre-plus post-treatment. Each panel is taken from a heart representative of one of the three experimental groups mentioned above. British Journal of Anaesthesia 2010 104, 414-421DOI: (10.1093/bja/aeq019) Copyright © 2010 The Author(s) Terms and Conditions

Fig 4 Electron microscopy of vascular endothelial glycocalyx without ischaemia (a), after 20 min of ischaemia and reperfusion without (b), and with sevoflurane pre- plus post-treatment (c). Each panel is taken from a heart representative of one of the three experimental groups mentioned above. Original magnifications all ×3640. British Journal of Anaesthesia 2010 104, 414-421DOI: (10.1093/bja/aeq019) Copyright © 2010 The Author(s) Terms and Conditions

Fig 5 Cathepsin B-like activity in coronary effluent during baseline conditions and the first 10 min of reperfusion. Data given as median, IQR (boxes), and full range (T-bars), n=6 each. #P < 0.05 0–10 min reperfusion IR vs baseline IR and baseline IR + Sevo; *P < 0.05 0–10 min reperfusion IR + Sevo vs reperfusion IR. British Journal of Anaesthesia 2010 104, 414-421DOI: (10.1093/bja/aeq019) Copyright © 2010 The Author(s) Terms and Conditions