Multicentric Standardized Flow Cytometry Routine Assessment of Patients With Sepsis to Predict Clinical Worsening

Daix, Thomas; Guérin, Estelle; Tavernier, Elsa; Mercier, Emmanuelle; Gissot, Valérie; Hérault, Olivier; Mira, Jean‐Paul; Dumas, Florence; Chapuis, Nicolas; Guitton, Christophe; Béné, Marie C.; Quenot, Jean‐Pierre; Tissier, Cindy; Guy, Julien; Piton, Gaël; Roggy, Anne; Muller, Grégoire; Legac, Éric; Prost, Nicolas de; Khellaf, Mehdi; Wagner-Ballon, Orianne; Coudroy, Rémi; Dindinaud, Elodie; Uhel, Fabrice; Roussel, Mikaël; Lafon, Thomas; Jeannet, Robin; Vargas, Frédéric; Fleureau, Catherine; Roux, Mickaël; Allou, Kaoutar; Vignon, Philippe; Feuillard, Jean; François, Bruno; Vittorio, Adollës Di; Lachot, Sébastien; Georget, M.; Hanna, Joëlle; Bretonnière, Cédric; Zambon, Olivier; Nicolet, Laurent; Brulé, Noëlle; Debord, Camille; Bris, Yannick Le; Robillard, Nelly; Dargent, Auguste; Bretagnol, Anne; Mathonnet, Armelle; Boulain, Thierry; Barbier, François; Benzekri, Dalila; Runge, Isabelle; Kamel, Toufik; Cecchini, Jérôme; Bouyer, Sabrina; Robert, R.; Ouattara, Alexandre

doi:10.1016/j.chest.2018.03.058

Cited by 51 publications

(56 citation statements)

References 38 publications

(50 reference statements)

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“…The post-CPB hyperleukocytosis observed in this study seems mainly related to an increase of neutrophil linked to IGs and monocyte counts related to HLA DR dim . Circulating T and NK cell compartments tended to be decreased but remained within normal ranges (4,(14)(15)(16)(17).…”

Section: Discussionmentioning

confidence: 99%

“…1A). Gating of IGs was performed as previously reported (14). Expression of CD10, CD16, and CD64 on granulocytes was assessed after exclusion of monocytes and lymphocytes ( Fig.…”

Section: Fcm and Biological Analysismentioning

confidence: 99%

“…1B-F). The thresholds to assess the CD10 dim and/or CD16 dim granulocytes were set up by comparison with 20 healthy controls so that more than 95% of controls exhibited <5% of CD10 dim or CD16 dim granulocytes ( Supplementary Figure 1) (14). Because the antibody against the DR molecule was associated with the antibody combination for T and NK cell subsets, gating of monocytes was based on a 2D projection of a CD3/CD4/SS 3D histogram (Kaluza* radar).…”

Section: Fcm and Biological Analysismentioning

confidence: 99%

“…During ICU stay, 6 patients needed reoperation for postoperative bleedings. The median ICU stay was 4 [3][4][5] and hospital stay was 11 [9][10][11][12][13][14] days. Two patients died during their hospitalization (mesenteric ischemia, postoperative multiple organ failure).…”

Section: Patient Characteristicsmentioning

confidence: 99%

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Immature Granulocytes: A Risk Factor of Infection after Cardiac Surgery

Daix

Guérin

Tavernier

et al. 2018

Cytometry Part B Clinical

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Background Similarly, to sepsis, cardiac surgery with cardiopulmonary bypass (CPB) induces major changes in leukocyte subsets. Immature granulocytes (IGs) increase both in sepsis and after open‐heart surgery. Secondary infections are a major complication of cardiac surgery with CPB. We hypothesized that the assessment of leukocyte subsets with multicolor flow cytometry (FCM) could help the front‐line clinician to better identify patients at high risk of infectious complications in this clinical setting. Methods In this single‐center observational pilot study, we identified 26 leukocyte subsets using three combinations of antibodies (from 5 to 10 colors per combinations): one devoted to granulocytes, one to lymphocyte subpopulations and one for rare cells (plasma cells and dendritic cells). Blood samples were obtained preoperatively and immediately after open‐heart surgery under CPB in 59 patients without immuno‐depression, chronic or neoplastic inflammatory disease, and immunosuppressive treatment. Secondary infections during hospital stay were recorded. Results Patients exhibited postoperative NK and T‐cell lymphopenia, increased levels of IGs and monocytes with low levels of surface HLA DR. Twelve patients developed secondary infectious complications. Only immediate postoperative IG levels were significantly higher in these patient (6.6 [6; 7.39] G/L vs. 3.8 [2.67; 5.72] G/L, P = 0.01). Patients with immediate postoperative increase of IGs developed more frequently infectious complication (10/22 [46%] vs. 2/37 [5%]: P < 0.001). Conclusions This study suggests that postoperative increase of IGs is related to postoperative organ failure and promises to help in early identification of patients at risk of infectious complications after open‐heart surgery under CPB. © 2018 International Clinical Cytometry Society

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Section: Discussionmentioning

confidence: 99%

“…1A). Gating of IGs was performed as previously reported (14). Expression of CD10, CD16, and CD64 on granulocytes was assessed after exclusion of monocytes and lymphocytes ( Fig.…”

Section: Fcm and Biological Analysismentioning

confidence: 99%

Section: Fcm and Biological Analysismentioning

confidence: 99%

Section: Patient Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

Immature Granulocytes: A Risk Factor of Infection after Cardiac Surgery

Daix

Guérin

Tavernier

et al. 2018

Cytometry Part B Clinical

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“…There is a rationale for this, as lymphocyte count was also the primary endpoint of the study. However, despite the fact that lymphopenia has been associated with deleterious outcomes [5,6], and that lymphocyte counts are available in most large hospitals, this biomarker has a poor performance in identifying patients with a poor *Correspondence: Julien.textoris@biomerieux.com 1 Joint Research Unit, Hospices Civils de Lyon-bioMérieux-Université Claude Bernard Lyon 1, EA7426 "Pathophysiology of Injury-Induced Immunosuppression (PI3)", Hôpital E. Herriot, Lyon, France Full author information is available at the end of the article prognosis. Indeed, association and prediction are two key features of a pertinent biomarker, but a strong association with one or more conditions does not necessarily mean a good positive/negative predictive value for a later medical event.…”

mentioning

confidence: 99%