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  1. Article ; Online: Platelet P2Y

    Rabouel, Yannick / Magnenat, Stéphanie / Delabranche, Xavier / Gachet, Christian / Hechler, Beatrice

    TH open : companion journal to thrombosis and haemostasis

    2021  Volume 5, Issue 3, Page(s) e343–e352

    Abstract: ... ...

    Abstract Introduction
    Language English
    Publishing date 2021-08-24
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2901738-5
    ISSN 2512-9465 ; 2567-3459
    ISSN (online) 2512-9465
    ISSN 2567-3459
    DOI 10.1055/s-0041-1733857
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Clinical pathologists and physician in France: which partnership and which future?

    Barrand, Lionel / Delabranche, Xavier

    Annales de biologie clinique

    2017  Volume 75, Issue 4, Page(s) 375–392

    Abstract: Medical biology is a major area of medical specialization in French health care system. It is going through massive changes in public as in private sector since the 2010 Ballereau edict with the merging of laboratories and new quality standards based on ... ...

    Title translation Biologistes médicaux et cliniciens en France : quel partenariat pour quel avenir ?
    Abstract Medical biology is a major area of medical specialization in French health care system. It is going through massive changes in public as in private sector since the 2010 Ballereau edict with the merging of laboratories and new quality standards based on accreditation. We have suggested that physicians had a negative feeling about the restructuring of medical biology in recent years. An electronic questionnaire has been sent to physicians so as to find out what they thought about the evolution of medical biology and to get suggestions to improve the taking care of the patient. Have answered 1364 residents and physicians from all specializations, all regions, practicing in public or private hospitals or in general practices. Doctors have on the whole a negative feeling about how medical biology has evolved in recent years thinking that it is moving towards industrialization with delay increasing. They are convinced that tests must be made on site. They remain satisfied with the quality of the tests and have a positive feeling about scientific evolutions and are in favor of a better clinical-biological cooperation. The study points out a lack of clarity concerning how private laboratories are organized and how they operate. A computer link between clinical pathologists and physicians to access results and a list of urgent medical examinations could be set up so as to have a more rapid access to results. Rapid diagnostic tests or delocalized biology could be used but doctors do not want these tests to replace the clinical pathologist.
    Language English
    Publishing date 2017-08-01
    Publishing country France
    Document type Journal Article
    ZDB-ID 2023584-7
    ISSN 1950-6112 ; 0003-3898
    ISSN (online) 1950-6112
    ISSN 0003-3898
    DOI 10.1684/abc.2017.1269
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Transfusion of fresh washed platelets does not prevent experimental polymicrobial-induced septic shock in mice.

    Rabouël, Yannick / Magnenat, Stéphanie / Lefebvre, Floryna / Delabranche, Xavier / Gachet, Christian / Hechler, Beatrice

    Journal of thrombosis and haemostasis : JTH

    2021  Volume 20, Issue 2, Page(s) 449–460

    Abstract: Introduction: The specific role of platelets during sepsis is not yet fully understood, probably related to the paradox of platelets being potentially beneficial but also deleterious via their thrombotic functions.: Objective: To evaluate the impact ... ...

    Abstract Introduction: The specific role of platelets during sepsis is not yet fully understood, probably related to the paradox of platelets being potentially beneficial but also deleterious via their thrombotic functions.
    Objective: To evaluate the impact of thrombocytopenia on septic shock in mice and to investigate whether transfusion of fresh washed platelets, either fully functional or with impaired hemostatic properties, might have beneficial effects.
    Methods: Septic shock was induced by cecal ligation and puncture (CLP). Experimental depletion of circulating platelets was induced with a rat anti-mouse GPIbα monoclonal antibody. Transfusion of either wild-type washed platelets, platelets treated with the antiplatelet drugs acetylsalicylic acid (ASA) and clopidogrel, or GPIIbIIIa-deficient washed platelets treated with ASA and clopidogrel was performed 4 h after CLP surgery.
    Results: Depletion of circulating platelets negatively affected septic shock, worsening systemic inflammation, coagulopathy, organ damage, and mortality, raising the question of whether a higher platelet count could be protective. Transfusion of fully functional platelets or platelets with combined treatment with ASA and clopidogrel, with or without additional GPIIbIIIa deficiency, afforded an immediate return of circulating platelet counts to their initial values before surgery. However, transfusion of each of the three types of platelets did not prevent arterial hypotension, inflammatory response, coagulopathy, and organ damage during septic shock.
    Conclusion: Depletion of circulating platelets negatively affects septic shock, while transfusion of washed platelets has no significant beneficial effect in mice.
    MeSH term(s) Animals ; Blood Platelets ; Mice ; Platelet Count ; Rats ; Sepsis ; Shock, Septic ; Thrombocytopenia/prevention & control
    Language English
    Publishing date 2021-11-17
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2112661-6
    ISSN 1538-7836 ; 1538-7933
    ISSN (online) 1538-7836
    ISSN 1538-7933
    DOI 10.1111/jth.15583
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.MO 295: Show issues

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  4. Article: Platelet P2Y12 Receptor Deletion or Pharmacological Inhibition does not Protect Mice from Sepsis or Septic Shock

    Rabouel, Yannick / Magnenat, Stéphanie / Delabranche, Xavier / Gachet, Christian / Hechler, Beatrice

    TH Open

    2021  Volume 05, Issue 03, Page(s) e343–e352

    Abstract: Introduction: Platelets are increasingly appreciated as key effectors during sepsis, raising the question of the usefulness of antiplatelet drugs to treat patients with sepsis.: Objective: Evaluate the potential contribution of the platelet P2Y 12 ... ...

    Abstract Introduction: Platelets are increasingly appreciated as key effectors during sepsis, raising the question of the usefulness of antiplatelet drugs to treat patients with sepsis.
    Objective: Evaluate the potential contribution of the platelet P2Y 12 receptor in the pathogenesis of polymicrobial-induced sepsis and septic shock in mice.
    Methods: The effects of P2Y 12 inhibition using clopidogrel treatment and of platelet-specific deletion of the P2Y 12 receptor in mice were examined in two severity grades of cecal ligation and puncture (CLP) leading to mild sepsis or septic shock.
    Results: Twenty hours after induction of the high grade CLP, clopidogrel- and vehicle-treated mice displayed a similar 30% decrease in mean arterial blood pressure (MAP) characteristic of shock. Septic shock-induced thrombocytopenia was not modified by clopidogrel treatment. Plasma concentrations of inflammatory cytokines and myeloperoxidase (MPO) were similarly increased in clopidogrel- and vehicle-treated mice, indicating comparable increase in systemic inflammation. Thrombin-antithrombin (TAT) complexes and the extent of organ damage were also similar. In mild-grade CLP, clopidogrel- and vehicle-treated mice did not display a significant decrease in MAP, while thrombocytopenia and plasma concentrations of TNFα, IL6, IL10, MPO, TAT and organ damage reached similar levels in both groups, although lower than those reached in the high grade CLP. Similarly, mice with platelet-specific deletion of the P2Y 12 receptor were not protected from CLP-induced sepsis or septic shock.
    Conclusion: The platelet P2Y 12 receptor does not contribute to the pathogenesis of sepsis or septic shock in mice, suggesting that P2Y 12 receptor antagonists may not be beneficial in patients with sepsis or septic shock.
    Keywords sepsis ; septic shock ; P2Y12 receptor ; clopidogrel treatment ; antiplatelet drug
    Language English
    Publishing date 2021-07-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2901738-5
    ISSN 2512-9465 ; 2567-3459
    ISSN (online) 2512-9465
    ISSN 2567-3459
    DOI 10.1055/s-0041-1733857
    Database Thieme publisher's database

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  5. Article: Study of Modifications Induced by Continued Direct Oral Anticoagulant Therapy during Atrial Fibrillation Ablation Procedures on Standard Hemostasis Parameters.

    Muller, Marie / Godet, Julien / Delabranche, Xavier / Sattler, Laurent / Millard, David / Marzak, Halim / Mertes, Paul Michel / Steib, Annick / Grunebaum, Lelia / Jesel, Laurence / Tacquard, Charles Ambroise

    Journal of clinical medicine

    2023  Volume 12, Issue 6

    Abstract: Background: Unfractionated heparin (UFH) is used as an anticoagulant during the atrial fibrillation (AF) ablation procedure to prevent the occurrence of thromboembolic events. Guidelines recommend an activated clotting time (ACT) greater than 300 s (s) ... ...

    Abstract Background: Unfractionated heparin (UFH) is used as an anticoagulant during the atrial fibrillation (AF) ablation procedure to prevent the occurrence of thromboembolic events. Guidelines recommend an activated clotting time (ACT) greater than 300 s (s) based on studies of patients treated with vitamin K antagonist (VKA) for their AF. However, direct oral anticoagulants (DOACs) have supplanted VKAs in AF and are now used as first-line therapy. It is recommended not to interrupt them during the procedure, which could interfere with the ACT measures.
    Objective: To assess the real-life relationship between ACT, DOAC concentrations, and UFH anti-Xa activity in patients treated by uninterrupted DOAC therapy.
    Methods: We conducted a single-center retrospective study. We analyzed consecutive patients with AF who underwent catheter ablation under DOAC therapy.
    Results: In total, 40 patients were included, including 15 (37.5%), 20 (50.0%), and 5 (12.5%) on rivaroxaban, apixaban, and dabigatran, respectively. Baseline ACT was significantly lower in the apixaban group. ACT was linearly correlated with the residual concentration of apixaban and dabigatran but not with rivaroxaban. After UFH injection, ACT was linearly correlated with the anti-Xa activity, regardless of DOAC. Patients in the apixaban group received a higher total dose of UFH during the procedure to achieve a target ACT > 300 s, which resulted in significantly higher anti-Xa activity during the procedure.
    Conclusion: Our results raise the question of optimal management of intra-procedural heparin therapy and highlight the limitations of the ACT test, particularly in patients on apixaban.
    Language English
    Publishing date 2023-03-14
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12062236
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Immunohaemostasis: a new view on haemostasis during sepsis.

    Delabranche, Xavier / Helms, Julie / Meziani, Ferhat

    Annals of intensive care

    2017  Volume 7, Issue 1, Page(s) 117

    Abstract: Host infection by a micro-organism triggers systemic inflammation, innate immunity and complement pathways, but also haemostasis activation. The role of thrombin and fibrin generation in host defence is now recognised, and thrombin has become a partner ... ...

    Abstract Host infection by a micro-organism triggers systemic inflammation, innate immunity and complement pathways, but also haemostasis activation. The role of thrombin and fibrin generation in host defence is now recognised, and thrombin has become a partner for survival, while it was seen only as one of the "principal suspects" of multiple organ failure and death during septic shock. This review is first focused on pathophysiology. The role of contact activation system, polyphosphates and neutrophil extracellular traps has emerged, offering new potential therapeutic targets. Interestingly, newly recognised host defence peptides (HDPs), derived from thrombin and other "coagulation" factors, are potent inhibitors of bacterial growth. Inhibition of thrombin generation could promote bacterial growth, while HDPs could become novel therapeutic agents against pathogens when resistance to conventional therapies grows. In a second part, we focused on sepsis-induced coagulopathy diagnostic challenge and stratification from "adaptive" haemostasis to "noxious" disseminated intravascular coagulation (DIC) either thrombotic or haemorrhagic. Besides usual coagulation tests, we discussed cellular haemostasis assessment including neutrophil, platelet and endothelial cell activation. Then, we examined therapeutic opportunities to prevent or to reduce "excess" thrombin generation, while preserving "adaptive" haemostasis. The fail of international randomised trials involving anticoagulants during septic shock may modify the hypothesis considering the end of haemostasis as a target to improve survival. On the one hand, patients at low risk of mortality may not be treated to preserve "immunothrombosis" as a defence when, on the other hand, patients at high risk with patent excess thrombin and fibrin generation could benefit from available (antithrombin, soluble thrombomodulin) or ongoing (FXI and FXII inhibitors) therapies. We propose to better assess coagulation response during infection by an improved knowledge of pathophysiology and systematic testing including determination of DIC scores. This is one of the clues to allocate the right treatment for the right patient at the right moment.
    Language English
    Publishing date 2017-12-02
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 2617094-2
    ISSN 2110-5820
    ISSN 2110-5820
    DOI 10.1186/s13613-017-0339-5
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  7. Article ; Online: Laboratory diagnosis of heparin-induced thrombocytopenia: A retrospective experience.

    Herb, Agathe / Depierreux, Mathilde / Wimmer, Jordan / Rolland, Delphine / Tebacher, Martine / Lambert, Aude / Ladhari, Chayma / Cristinar, Mircea / Delabranche, Xavier / Krummel, Thierry / Paya, Dominique / Schenck, Maleka / Mauvieux, Laurent / Sattler, Laurent

    Journal of clinical laboratory analysis

    2023  Volume 37, Issue 7, Page(s) e24884

    Abstract: Background: Heparin-induced thrombocytopenia (HIT) is a severe complication of heparin therapy associated with thrombosis that requires a quick diagnosis. Therefore, laboratory assays must provide an accurate and swift answer. This work aims to evaluate ...

    Abstract Background: Heparin-induced thrombocytopenia (HIT) is a severe complication of heparin therapy associated with thrombosis that requires a quick diagnosis. Therefore, laboratory assays must provide an accurate and swift answer. This work aims to evaluate the performances of an ELISA assay, especially when combined with 4T risk score, and a functional assay.
    Methods: Data were collected for 894 patients treated by heparin who underwent anticoagulant switch because of HIT suspicion and were examined by a multidisciplinary expert team who confirmed or ruled out HIT diagnosis. All patients were tested for anti-PF4 IgG with Asserachrom HPIA IgG (ELISA), and 307 were tested with a platelet aggregation test done on platelet-rich plasma (PRP-PAT). The 4T risk score was available for 607 of them.
    Results: HIT was diagnosed in 232 patients. 4T risk score had a 94.2% negative predictive value (NPV) for risk scores ≤3 and 77.3% for risk scores ≤5. The sensitivity of ELISA was 90.9%, its specificity 79.0%, and its NPV 96.1%. When combined with 4T risk score, its NPV reached 100% and 97% for risk scores ≤3 and ≤5, respectively. PRP-PAT sensitivity was 70.4%, and its specificity was 92.3%. Combination of ELISA and PRP-PAT had a 0.7% false-negative rate.
    Conclusion: This study shows that ELISA can rule out HIT with an excellent NPV, especially when combined with the 4T risk score. Nonetheless, it has low specificity; hence, it needs to be associated with a functional assay.
    MeSH term(s) Humans ; Retrospective Studies ; Platelet Factor 4/adverse effects ; Thrombocytopenia/chemically induced ; Thrombocytopenia/diagnosis ; Heparin/adverse effects ; Anticoagulants/adverse effects ; Enzyme-Linked Immunosorbent Assay ; Platelet Function Tests ; Immunoglobulin G
    Chemical Substances Platelet Factor 4 (37270-94-3) ; Heparin (9005-49-6) ; Anticoagulants ; Immunoglobulin G
    Language English
    Publishing date 2023-04-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645095-7
    ISSN 1098-2825 ; 0887-8013
    ISSN (online) 1098-2825
    ISSN 0887-8013
    DOI 10.1002/jcla.24884
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    Zs.A 2471: Show issues Location:
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  8. Article ; Online: Platelet dysfunction and thrombus instability in flow conditions in patients with severe COVID-19.

    Tacquard, Charles / Mouriaux, Clarisse / Delabranche, Xavier / Bourdon, Catherine / Eckly, Anita / Magnenat, Stéphanie / Sattler, Laurent / Gachet, Christian / Mertes, Paul Michel / Hechler, Beatrice / Mangin, Pierre H

    Thrombosis research

    2022  Volume 221, Page(s) 137–148

    Abstract: Severe COVID-19 has been associated with a high rate of thrombotic events but also of bleeding events, particularly when the level of prophylactic anticoagulation was increased. Data on the contribution of platelets to these thrombotic events are ... ...

    Abstract Severe COVID-19 has been associated with a high rate of thrombotic events but also of bleeding events, particularly when the level of prophylactic anticoagulation was increased. Data on the contribution of platelets to these thrombotic events are discordant between reports, while the involvement of platelets in bleeding events has never been investigated. The objective of the present study was to assess platelet function during the first week of ICU hospitalization in patients with severe COVID-19 pneumonia. A total of 35 patients were prospectively included and blood samples were drawn on day (D) 0, D2 and D7. COVID-19 pneumonia was severe with a median PaO
    Language English
    Publishing date 2022-11-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 121852-9
    ISSN 1879-2472 ; 0049-3848
    ISSN (online) 1879-2472
    ISSN 0049-3848
    DOI 10.1016/j.thromres.2022.11.004
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  9. Article ; Online: Impact of COVID-19 and lockdown regarding blood transfusion.

    Delabranche, Xavier / Kientz, Daniel / Tacquard, Charles / Bertrand, Françoise / Roche, Anne-Claude / Tran Ba Loc, Pierre / Humbrecht, Catherine / Sirlin, Florian / Pivot, Xavier / Collange, Olivier / Levy, François / Oulehri, Walid / Gachet, Christian / Mertes, Paul-Michel

    Transfusion

    2021  Volume 61, Issue 8, Page(s) 2327–2335

    Abstract: Background: The outbreak of a SARS-CoV-2 resulted in a massive afflux of patients in hospital and intensive care units with many challenges. Blood transfusion was one of them regarding both blood banks (safety, collection, and stocks) and consumption ( ... ...

    Abstract Background: The outbreak of a SARS-CoV-2 resulted in a massive afflux of patients in hospital and intensive care units with many challenges. Blood transfusion was one of them regarding both blood banks (safety, collection, and stocks) and consumption (usual care and unknown specific demand of COVID-19 patients). The risk of mismatch was sufficient to plan blood transfusion restrictions if stocks became limited.
    Study design and methods: Analyses of blood transfusion in a tertiary hospital and blood collection in the referring blood bank between February 24 and May 31, 2020.
    Results: Withdrawal of elective surgery and non-urgent care and admission of 2291 COVID-19 patients reduced global activity by 33% but transfusion by 17% only. Only 237 (10.3) % of COVID-19 patients required blood transfusion, including 45 (2.0%) with acute bleeding. Lockdown and cancellation of mobile collection resulted in an 11% reduction in blood donation compared to 2019. The ratio of reduction in blood transfusion to blood donation remained positive and stocks were slightly enhanced.
    Discussion: Reduction of admissions due to SARS-CoV-2 pandemic results only in a moderate decrease of blood transfusion. Incompressible blood transfusions concern urgent surgery, acute bleeding (including some patients with COVID-19, especially under high anticoagulation), or are supportive for chemotherapy-induced aplasia or chronic anemia. Lockdown results in a decrease of blood donation by cancellation of mobile donation but with little impact on a short period by mobilization of usual donors. No mismatch between demand and donation was evidenced and no planned restriction to blood transfusion was necessary.
    MeSH term(s) Blood Banks ; Blood Donors ; Blood Transfusion ; COVID-19/epidemiology ; COVID-19/prevention & control ; Communicable Disease Control ; Humans ; Retrospective Studies ; SARS-CoV-2/isolation & purification ; Tertiary Care Centers
    Language English
    Publishing date 2021-07-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 208417-x
    ISSN 1537-2995 ; 0041-1132
    ISSN (online) 1537-2995
    ISSN 0041-1132
    DOI 10.1111/trf.16422
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  10. Article ; Online: Acute Pulmonary Embolism in Patients with COVID-19 at CT Angiography and Relationship to d-Dimer Levels.

    Léonard-Lorant, Ian / Delabranche, Xavier / Séverac, François / Helms, Julie / Pauzet, Coralie / Collange, Olivier / Schneider, Francis / Labani, Aissam / Bilbault, Pascal / Molière, Sébastien / Leyendecker, Pierre / Roy, Catherine / Ohana, Mickaël

    Radiology

    2020  Volume 296, Issue 3, Page(s) E189–E191

    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Betacoronavirus ; COVID-19 ; Computed Tomography Angiography ; Coronavirus Infections/complications ; Coronavirus Infections/diagnostic imaging ; Coronavirus Infections/epidemiology ; Coronavirus Infections/metabolism ; Female ; Fibrin Fibrinogen Degradation Products/analysis ; Humans ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/diagnostic imaging ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/metabolism ; Pulmonary Embolism/diagnostic imaging ; Pulmonary Embolism/epidemiology ; Pulmonary Embolism/metabolism ; Pulmonary Embolism/virology ; Retrospective Studies ; SARS-CoV-2
    Chemical Substances Fibrin Fibrinogen Degradation Products ; fibrin fragment D
    Keywords covid19
    Language English
    Publishing date 2020-04-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80324-8
    ISSN 1527-1315 ; 0033-8419
    ISSN (online) 1527-1315
    ISSN 0033-8419
    DOI 10.1148/radiol.2020201561
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