Murphy LS, et al. - This study focused on the glycocalyx degradation in sepsis-induced acute respiratory distress syndrome (ARDS) and for this purpose, plasma levels of syndecan-1 were measured in ventilated medical ICU patients at risk of ARDS due to severe sepsis and acute physiology and chronic health evaluation II (APACHE II) ≥ 25. Findings demonstrated an association of the extent of endothelial glycocalyx degradation with non-pulmonary organ dysfunction in sepsis patients and, with ARDS but only in the subgroup with non-pulmonary sepsis. Overall, syndecan-1 levels possibly have utility in detecting high risk of organ dysfunction and mortality in sepsis patients and identifying those who could benefit from therapies targeted at protecting or restoring the glycocalyx.