Septic Shock
Conditions
Keywords
leukocyte and platelet aggregates, platelet activation
Brief summary
Some studies have shown that antiplatelets agents could reduce organ dysfunction in septic shock in mice and human models. Platelets are actors in immunity and their activation can be complicated by tissue damage with vascular occlusions which can lead to organ dysfunction. Investigators can hypothesize an increase in platelet activation and in leukocyte-platelet aggregates in septic shock.
Interventions
OTHERSeptic choc group
Specific platelet activation markers, circulating leukocyte-platelet aggregates will be assessed in peripheral venous blood at the admission in intensive care unit and 48 hours later for leukocyte-platelet aggregates measurements.
OTHEROrthopedic surgery group
Specific platelet activation markers, circulating leukocyte-platelet aggregates will be assessed in peripheral venous blood during the orthopedic surgical anesthesia consultation.
Sponsors
Institut National de la Santé Et de la Recherche Médicale, France
University Hospital, Toulouse
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
EXPERIMENTAL GROUP * Patient who possibly gave an oral agreement to inclusion and may sign a consent once out of intensive care * Patients hospitalized in general intensive care * Patient hospitalized for less than 72 hours * Patient suffering from severe sepsis, whatever their origin, with hypotension (PAs \<90mmHg) despite adequate fluid resuscitation and vasoactive requiring the use of amines, with hypoperfusion and / or at least one organ dysfunction ( septic shock) * Patient with a Sequential Organ Failure Assessment (SOFA) score\> 8 (or\> 2 in an organ) in the first 24 hours * Patient enjoying a social security scheme or equivalent CONTROL GROUP * Signed informed consent * Patient seen anesthesia consultation for orthopedic knee prosthesis of laying or hip with a negative balance infectious * Patient enjoying a social security scheme or equivalent
Exclusion criteria
EXPERIMENTAL GROUP * Patient on safeguarding justice, guardianship * Patient suffering from a haematological malignancy (leukemia, lymphoma ...) * Patient suffering from thrombocytopenia or constitutional thrombopathy * Pregnant CONTROL GROUP * Patient on safeguarding justice, guardianship * Patient with infectious positive balance (dental, urinary tract) prior to surgery * Patient suffering from a haematological malignancy (leukemia, lymphoma ...) * Patient suffering from thrombocytopenia or constitutional thrombopathy * Pregnant
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Level of platelets activation markers expression (CD62-P, antibody CD63, CD42b) | T0 at the admission in intensive care unit | Specific platelet activation markers and circulating leukocyte-platelet aggregates will be assessed in peripheral venous blood at the admission in intensive care unit for patients in test group and during the orthopedic surgical anesthesia consultation for patients in control group. |
| Level of platelets activation markers expression (CD62-P, CD63, CD42b) | T48 hours after admission in intensive care unit | Specific platelet activation markers and circulating leukocyte-platelet aggregates will be assessed in peripheral venous blood 48 hours later admission in intensive care unit only for patients in test group. |
Secondary
| Measure | Time frame |
|---|---|
| Rate of leukocyte-platelet aggregates | T0 at the admission in intensive care unit |
| Kinetics of leukocyte-platelet aggregates formation | T0 at the admission in intensive care unit |
| Correlation of leukocyte-platelet aggregates rate and septic shock severity. | T0 at the admission in intensive care unit |
| Comparison of platelet activation in subjects treated or not with antiplatelet agents. | T0 at the admission in intensive care unit |
Countries
France
Outcome results
None listed