Endothelial Function, Platelet Transfusion, Prophylactic Platelet Transfusion, Thrombocytopenia
Conditions
Keywords
ICU, intensive care, Platelet Transfusion, Endothelial Function, endothelial biomarkers, systemic inflammation, oxidative stress, peripheral tissue perfusion
Brief summary
This study aims to investigate the impact of platelet concentrate (PC) transfusions on endothelial function and the systemic inflammatory response in thrombopenic patients admitted to intensive care who require prophylactic platelet transfusions. Endothelial function will be measured using a laser Doppler device coupled with an acetylcholine iontophoresis system that is applied to the skin.
Detailed description
This is a single-centre, non-randomised, non-interventional human research study (RIPH3) investigating the impact of platelet transfusion on endothelial function, endothelial biomarkers, systemic inflammation, oxidative stress and peripheral tissue perfusion. Patients will be recruited during their stay in intensive care, after receiving information and providing their consent (non opposition). Platelet transfusion will be prescribed as part of their treatment. Before the transfusion, at the end of the transfusion and one hour afterwards, a clinical examination will be performed, along with an assessment of tissue perfusion and microcirculatory blood flow measurements using a Doppler laser coupled with iontophoresis. Blood samples will be taken before the transfusion and one hour after its completion to assess the systemic inflammatory response. Participation in this research study will take a maximum of four hours. No specific follow-up is planned for patients included in the study.
Interventions
None listed
Sponsors
Assistance Publique - Hôpitaux de Paris
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patient ≥ 18 years of age * Admitted to intensive care * Requires prophylactic platelet transfusion for thrombocytopenia * Enrolled in a social security program * No objection to participating in the study
Exclusion criteria
* Recent platelet or red blood cell transfusion (\< 24 hours) * Need for urgent red blood cell transfusion due to active bleeding * Patient under guardianship or conservatorship * Significant peripheral edema
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Assessing the effects of platelet transfusion on endothelial function in the microcirculation. Endothelial function will be measured using a Doppler laser coupled with an acetylcholine iontophoresis system applied to the skin. | before transfusion, right after transfusion and 1 hour after transfusion | The area under the microcirculatory blood flow curve is measured over 10 minutes using a cutaneous laser Doppler sensor coupled with iontophoresis (Périmed, France). The data is analysed using computer software connected to the Doppler device. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Oxidative stress | before transfusion and 1 hour after transfusion | Oxidative stress will be assessed by mass spectrometry. |
| Peripheral tissue perfusion | before transfusion, right after transfusion and 1 hour after transfusion | Peripheral tissue perfusion will be assessed by measuring skin recolouration time |
| Systemic inflammatory biomarker levels | before transfusion and 1 hour after transfusion | Systemic inflammation will be assessed by measuring C-reactive protein (CRP), leukocyte count, interleukin (IL)-1β, IL-6, tumor necrosis factor-α (TNF-α), IL-10, CCL2, CCL5, CXCL1, and circulating microparticles. |
| Urine output | before transfusion, right after transfusion and 1 hour after transfusion | Peripheral tissue perfusion will be assessed by measuring urine output. |
| Endothelial biomarker levels | before transfusion and 1 hour after transfusion | Endothelial response will be assessed by measuring circulating levels of syndecan-1, hyaluronic acid, ICAM-1, VCAM-1, E-selectin, endothelial protein C receptor (EPCR), and von Willebrand factor. |
| Skin blood flow | before transfusion, right after transfusion and 1 hour after transfusion | Peripheral tissue perfusion will be assessed by measuring skin blood flow in the index finger using a skin Doppler sensor. |
Countries
France
Contacts
CONTACTHafid AIT-OUFELLA, Pr
PRINCIPAL_INVESTIGATORHafid AIT-OUFELLA, Pr
APHP
Outcome results
None listed