Observational studyCritical care (London, England)2026
Early detection of glycocalyx and microvascular damage in suspected sepsis in the emergency department: the EDGE study.
Observational study in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03126032 (Early Detection of Glycocalyx Damage in Emergency Room Patients), which is not on this map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Early Detection of Glycocalyx Damage in Emergency Room Patients
Who cites it
1 citing paper in PubMed.
- Converging evidence for a two-domain framework of microvascular dysfunction in sepsis.Critical care (London, England) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe prompt identification of clinical deterioration in emergency department (ED) patients presenting with infection is crucial yet challenging. Microvascular dysfunction has been linked to poor clinical outcome in critically ill patients, but it remains unclear whether its detection can predict clinical deterioration in early sepsis. This study aims to evaluate the utility of quantitative microvascular videomicroscopy for predicting clinical deterioration in patients with suspected sepsis.
methodsIn this prospective observational study, 299 ED patients with suspected infection or sepsis were enrolled, with the addition of 50 healthy volunteers, 14 non-infected ED patients and 34 intensive care unit (ICU) patients with sepsis as controls. All participants underwent sublingual sidestream darkfield videomicroscopy. The GlycoCheck™ software quantified vascular density, perfused boundary region (PBR; inverse marker of endothelial glycocalyx (eGC) thickness), and the Microvascular Health Score (MVHS™), which integrated capillary density and eGC dimensions. The primary outcome was disease progression within the first week, defined as progression from infection to sepsis or increase in SOFA score in septic patients. Secondary outcomes included in-hospital and 90-day mortality, ICU admission, or a composite outcome of progression or in-hospital death.
resultsSublingual videomicroscopy revealed significant differences in all microvascular variables between ED patients, healthy volunteers and control groups, correlating with disease severity. ED patients with disease progression showed lower capillary density, higher PBR, and lower MVHS at baseline than non-progressors. In patients presenting with infection without sepsis, MVHS demonstrated strong predictive discrimination for progression (AUC 0.79, p < 0.0001), outperforming procalcitonin and interleukin-6. An intact microvascular phenotype (high capillary density and low PBR) markedly reduced the risk of disease progression or in-hospital mortality (OR 0.17, p < 0.001), whereas combined glycocalyx damage and reduced capillary density significantly increased risk (OR 2.39, p = 0.01).
conclusionQuantitative sublingual videomicroscopy predicts early disease progression within the first week and stratifies patients with suspected sepsis into high and low-risk groups at ED presentation.
trial registrationClinicaltrials.gov Identifier NCT03126032, Registration Date 20.02.2017.
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