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Intensive Care Med (2013) 39:16951703DOI 10.1007/s00134-013-2993-x SEVEN-DAY PROFILE PUBLICATION
Microparticles are new biomarkers of septic shock-induced disseminated intravascular coagulopathy
Xavier Delabranche Julie Boisram-Helms Pierre AsfarAsal Berger Yoganaden Mootien Thierry Lavigne Llia Grunebaum Franois Lanza Christian Gachet Jean-Marie Freyssinet Florence TotiFerhat Meziani
Received: 8 May 2013Accepted: 4 June 2013Published online: 21 June 2013 Springer-Verlag Berlin Heidelberg and
ESICM 2013
Clinicaltrial.gov identier NCT 01604551
Electronic supplementary materialThe online version of this article (doi:http://dx.doi.org/10.1007/s00134-013-2993-x
Web End =10.1007/s00134-013-2993-x ) contains supplementary material, which is available to authorized users.
X. Delabranche J. Boisram-Helms
A. Berger F. Meziani ())
Service de Ranimation Mdicale, Nouvel Hpital Civil, Hpitaux Universitaires de Strasbourg, 1, Place de lHpital,67091 Strasbourg Cedex, Francee-mail: [email protected] Tel.: ?33-3-69550434Fax: ?33-3-69551859
X. Delabranche J. Boisram-Helms
A. Berger F. Meziani
EA 3072, Fdration de Mdecine Translationnelle de Strasbourg (FMTS), Facult de Mdecine, Universit de Strasbourg, Strasbourg, France
P. AsfarService de Ranimation Mdicale et Mdecine Hyperbare, Centre Hospitalier Universitaire dAngers, Angers, France
Y. MootienService de Ranimation Mdicale, Centre Hospitalier de Mulhouse, Mulhouse, France
T. LavigneEA 4438, Facult de Mdecine, Universit de Strasbourg, Strasbourg, France
L. GrunebaumLaboratoire dhmatologie et Hmostase, Hpital de Hautepierre, Hpitaux Universitaires de Strasbourg, Strasbourg, France
F. Lanza C. Gachet
UMR S949 INSERM,Universit de Strasbourg ettablissement Franais du Sang-Alsace,Strasbourg, France
J.-M. FreyssinetU770 INSERM, Facult de Mdecine, Universit Paris-Sud, Le Kremlin-Bictre, Orsay, France
F. TotiUMR 7213 CNRS, Facult de Pharmacie, Universit de Strasbourg, Illkirch, France
Abstract Purpose: Septic shock-induced disseminated intravascular coagulopathy (DIC) contributes to multiple organ failure. Mechanisms governing vascular responses to open occurrence of DIC have not yet been established. Circulating plasma microparticles (MPs), released upon cell stress, constitute a catalytic procoagulant surface and are surrogates of vascular cell activation/injury. Herein, MPs were assessed as possible markers of haemostatic and vascular
dysfunction in the DIC time course. Methods: One hundred patients with septic shock from three ICUs were enrolled and their haemostatic status evaluated at admission (D1), D2, D3 and D7. Circulating procoagulant MPs were isolated, quantied by prothrombinase assay and their cellular origin determined. DIC diagnosis was made according to the JAAM 2006 score. Results: Ninety-two patients were analysed and 40 had DIC during the rst 24 h. Routine clotting times and factor/inhibitor activity did not allow assessing vascular cell involvement. At admission, thrombin generation and brinolysis were...