0137: Endothelial-derived microparticles contribute to disseminated intravascular coagulopathy during septic shock

IntroductionSeptic shock-induced disseminated intravascular coagulopathy (DIC) contributes to endothelial dysfunction, multiple organ failure and high mortality rate. Our aim was to assess the interest of procoagulant microparticles (MPs) as surrogates of vascular cell and as possible biomarkers in DIC.Patients and methodsProspective multicenter study of 100 consecutive adult patients with septic shock enrolled at admission in medical intensive care units. Hemostasis parameters were analyzed, MPs measured by prothrombinase assay after capture onto insolubilized annexin-5 or biotinylated antibodies.ResultsAmong analyzed 92 cases, 40 had DIC during the first 24 hours. Routine clotting and hemostasis assays failed to identify vascular cell involvement. Compared to normal range, patients with septic shock had a three-fold increase (p<0.001) in total MPs at D1, remaining elevated at D7, regardless of DIC diagnosis. Regardless of the presence of DIC (p=0.15), endothelial cell apoptosis was suggested by a major increase in CD31-MPs that remained elevated until D7 (p=0.19). Endothelial activation was assessed by CD105-MPs, which remained dramatically increased in DIC (DIC at D1: 2.7·2.4nM and DIC at D2: 1.8·1.7nM, vs. no DIC: 0.8·0.6nM, p<0.001) and tended to return to baseline at the end of the follow-up period (p