Neutrophil Fluorescence: A New Indicator of Cell Activation During Septic Shock–Induced Disseminated Intravascular Coagulation

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Abstract

Objective:

To investigate the contribution of neutrophil activation as innate immune cells during septic shock–induced disseminated intravascular coagulation.

Design:

Prospective study.

Setting:

One University Hospital ICU.

Participants:

Hundred patients with septic shock. Thirty-five patients had disseminated intravascular coagulation according to Japanese Association for Acute Medicine 2006 score.

Intervention:

None.

Measurements and Main Results:

Neutrophil chromatin decondensation was assessed by measuring neutrophil fluorescence (NEUT-side-fluorescence light) labeled by a fluorochrome-based polymethine reagent using a routine automated flow cytometer Sysmex XN20 (Sysmex, Kobe, Japan) and neutrophil-derived CD66b microparticles by prothrombinase assay. Measurements in disseminated intravascular coagulation and no disseminated intravascular coagulation patients showed that a mean value of NEUT-side-fluorescence light above 57.3 arbitrary units had a sensitivity of 90.91% and a specificity of 80.60% for disseminated intravascular coagulation diagnosis. NEUT-side-fluorescence light was correlated to the CD66b microparticles/neutrophil count, a surrogate of neutrophil activation associated with septic shock–induced disseminated intravascular coagulation.

Conclusion:

NEUT-side-fluorescence light, routinely available, could prove an accurate biomarker of neutrophil activation.

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