108 results on '"Huskens D"'
Search Results
2. Differences in thrombin and plasmin generation potential between East African and Western European adults: The role of genetic and non-genetic factors
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Temba, G.S., Vadaq, N., Wan, J., Kullaya, V., Huskens, D., Pecht, T., Jaeger, M., Boahen, C.K., Matzaraki, V., Broeders, W., Joosten, L.A.B., Faradz, S.M., Kibiki, G.S., Middeldorp, S., Cavalieri, D., Lionetti, P., Groot, P.G. de, Schultze, J.L., Netea, M.G., Kumar, V., Laat, B. de, Mmbaga, B.T., Ven, A.J. van der, Roest, M., Mast, Q. de, Temba, G.S., Vadaq, N., Wan, J., Kullaya, V., Huskens, D., Pecht, T., Jaeger, M., Boahen, C.K., Matzaraki, V., Broeders, W., Joosten, L.A.B., Faradz, S.M., Kibiki, G.S., Middeldorp, S., Cavalieri, D., Lionetti, P., Groot, P.G. de, Schultze, J.L., Netea, M.G., Kumar, V., Laat, B. de, Mmbaga, B.T., Ven, A.J. van der, Roest, M., and Mast, Q. de
- Abstract
Item does not contain fulltext, BACKGROUND: Geographic variability in coagulation across populations and their determinants are poorly understood. OBJECTIVE: To compare thrombin (TG) and plasmin (PG) generation parameters between healthy Tanzanian and Dutch individuals, and to study associations with inflammation and different genetic, host and environmental factors. METHODS: TG and PG parameters were measured in 313 Tanzanians of African descent living in Tanzania and 392 Dutch of European descent living in the Netherlands and related to results of a dietary questionnaire, circulating inflammatory markers, genotyping, and plasma metabolomics. RESULTS: Tanzanians exhibited an enhanced TG and PG capacity, compared to Dutch participants. A higher proportion of Tanzanians had a TG value in the upper quartile with a PG value in the lower/middle quartile, suggesting a relative pro-coagulant state. Tanzanians also displayed an increased normalized thrombomodulin sensitivity ratio, suggesting reduced sensitivity to protein C. In Tanzanians, PG parameters (lag time and TTP) were associated with seasonality and food-derived plasma metabolites. The Tanzanians had higher concentrations of pro-inflammatory cytokines, which correlated strongly with TG and PG parameters. There was limited overlap in genetic variation associated with TG and PG parameters between the two cohorts. Pathway analysis of genetic variants in the Tanzanian cohort revealed multiple immune pathways that were enriched with TG and PG traits, confirming the importance of co-regulation between coagulation and inflammation. CONCLUSIONS: Tanzanians have an enhanced TG and PG potential compared to Dutch individuals, which may relate to differences in inflammation, genetics and diet. These observations highlight the importance of better understanding of the geographic variability in coagulation across populations.
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- 2022
3. Hyperresponsive Platelets and a Reduced Platelet Granule Release Capacity Are Associated with Severity and Mortality in COVID-19 Patients
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Garishah, F.M., Huskens, D., Pramudo, S.G., Andriani, D., Astrilia, M., Sentosa, R.A., Ven, A.J.A.M. van der, Laat, B. de, Gasem, M.H., Mast, Q. de, Roest, M., Garishah, F.M., Huskens, D., Pramudo, S.G., Andriani, D., Astrilia, M., Sentosa, R.A., Ven, A.J.A.M. van der, Laat, B. de, Gasem, M.H., Mast, Q. de, and Roest, M.
- Abstract
Item does not contain fulltext, BACKGROUND: Coronavirus disease 2019 (COVID-19) is often associated with mild thrombocytopenia and increased platelet reactivity. OBJECTIVE: The aim of the current study was to investigate the adenosine triphosphate (ATP) release kinetics of platelets in hospitalized SARS-CoV-2-infected patients. METHODS: We studied time-dependent platelet activation in whole blood by monitoring the ATP release kinetics upon stimulation with a PAR1 receptor agonist in 41 hospitalized critically ill COVID-19 patients, 47 hospitalized noncritically ill COVID-19 patients, and 30 healthy controls. RESULTS: Our study demonstrated that platelets of critically ill COVID-19 patients were hyper-responsive with a shorter platelet response time (PRT) and a reduced platelet granule release capacity (GRC), probably due to chronic activation. The median PRT of COVID-19 patients admitted to the critical care unit was 10 and 7 seconds shorter than the median PRT in healthy controls and noncritical COVID-19 patients, respectively. Both PRT and GRC were also associated with D-dimer (Spearman r [r (s)] = -0.51, p < 0.0001 and r (s) = -0.23, p < 0.05), C-reactive protein (CRP) (r (s) = -0.59, p < 0.0001 and r (s) = -0.41, p < 0.01), and neutrophil-to-lymphocyte ratio (NLR) (r (s) = -0.42, p < 0.0001 and r (s) = -0.26, p < 0.05). Moreover, an increased PRT and a reduced GRC were associated with an increased mortality (odds ratio [OR]: 18.8, 95% confidence interval [CI]: 6.5-62.8, p < 0.0001 and OR: 4.0; 95% CI: 1.6-10.4, p < 0.01). These relationships remained significant after adjustment for age, sex, D-dimer, CRP, and NLR. CONCLUSION: Using an accessible agonist-induced platelet granule ATP release assay, we show that platelet hyper-responsiveness and reduced platelet GRC in COVID-19 patients were associated with critical illness and mortality.
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- 2022
4. Haemostatic differences between SARS-CoV-2 PCR-positive and negative patients at the time of hospital admission
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de Laat, B., primary, Traets, M. J. M., additional, De Laat-Kremers, R. W. M., additional, Verweij, S. P., additional, Ninivaggi, M., additional, Jong, E., additional, Huskens, D., additional, Blok, B. A., additional, Remme, G. C. P., additional, Miszta, A., additional, Nijhuis, R. H. T., additional, Herder, G. J. M., additional, Fijnheer, R., additional, Roest, M., additional, Fiolet, A. T. L., additional, and Remijn, J. A., additional
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- 2022
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5. Simultaneous measurement of thrombin generation and fibrin formation in whole blood applying continuous flow is indicative for the amount of blood loss during/after cardiothoracic surgery: OR301
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Pelkmans, L, Kelchtermans, H, Bouwhuis, A, Schurgers, E, Lindhout, T, Huskens, D, Hemker, C, Lancé, M D, and de Laat, B
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- 2015
6. Novel diversity of plasmatic thrombin pools to regulate blood clotting: interference by an anti-fibrin nanobody.
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Sun, S., Konings, J., Urbanus, R. T., Huskens, D., Swieringa, F., Kremers, R.D. L., Zou, J., de Groot, P. G., Roest, M., Heemskerk, J. W., and de Laat, B.
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- 2024
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7. Evaluation of a panel of 28 biomarkers for the non-invasive diagnosis of endometriosis
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Vodolazkaia, A., El-Aalamat, Y., Popovic, D., Mihalyi, A., Bossuyt, X., Kyama, C.M., Fassbender, A., Bokor, A., Schols, D., Huskens, D., Meuleman, C., Peeraer, K., Tomassetti, C., Gevaert, O., Waelkens, E., Kasran, A., De Moor, B., and DʼHooghe, T.M.
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- 2012
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8. Activated CD4+CD25+ regulatory T cells inhibit osteoclastogenesis and collagen-induced arthritis
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Kelchtermans, H, Geboes, L, Mitera, T, Huskens, D, Leclercq, G, and Matthys, P
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- 2009
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9. A Novel Plasminogen Activator Anti-fibrin-uPA Increases the Sensitivity of the Plasmin Generation Assay to Therapeutic Target PAI-1.
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De Simone, I., Roest, M., Wolberg, A. S., de Laat, B., and Huskens, D.
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- 2024
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10. Concurrent interference of thrombin and fibrin fiber generation by a novel nanobody.
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Sun, S., Konings, J., Huskens, D., Kremers, R.D. L., Swieringa, F., Zou, J., de Groot, P. G., de Laat, B., Heemskerk, J. W., and Roest, M.
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- 2024
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11. Platelet Activation By Collagen Can Initiate Coagulation, Independent Of Factor Xii And Tissue Factor
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Li, L., primary, Huskens, D., additional, de Groot, P.G., additional, Roest, M., additional, and de Laat, B., additional
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- 2019
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12. High prevalence of reduced thrombin generation and/or decreased platelet response in women with unexplained heavy menstrual bleeding
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Eising, H P, Roest, M, de Groot, P G, Huskens, D, Konings, J, Urbanus, R T, de Laat, B, Remijn, J A, Eising, H P, Roest, M, de Groot, P G, Huskens, D, Konings, J, Urbanus, R T, de Laat, B, and Remijn, J A
- Published
- 2018
13. High prevalence of reduced thrombin generation and/or decreased platelet response in women with unexplained heavy menstrual bleeding
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CDL Cluster Onderzoek en Onderwijs, Poli Van Creveldkliniek Medisch, Circulatory Health, Eising, H P, Roest, M, de Groot, P G, Huskens, D, Konings, J, Urbanus, R T, de Laat, B, Remijn, J A, CDL Cluster Onderzoek en Onderwijs, Poli Van Creveldkliniek Medisch, Circulatory Health, Eising, H P, Roest, M, de Groot, P G, Huskens, D, Konings, J, Urbanus, R T, de Laat, B, and Remijn, J A
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- 2018
14. High prevalence of reduced thrombin generation and/or decreased platelet response in women with unexplained heavy menstrual bleeding
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Eising, H. P., primary, Roest, M., additional, de Groot, P. G., additional, Huskens, D., additional, Konings, J., additional, Urbanus, R. T., additional, de Laat, B., additional, and Remijn, J. A., additional
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- 2018
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15. 36th International Symposium on Intensive Care and Emergency Medicine
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Bateman, R. M., Sharpe, M. D., Jagger, J. E., Ellis, C. G., Solé-Violán, J., López-Rodríguez, M., Herrera-Ramos, E., Ruíz-Hernández, J., Borderías, L., Horcajada, J., González-Quevedo, N., Rajas, O., Briones, M., Rodríguez de Castro, F., Rodríguez Gallego, C., Esen, F., Orhun, G., Ergin Ozcan, P., Senturk, E., Ugur Yilmaz, C., Orhan, N., Arican, N., Kaya, M., Kucukerden, M., Giris, M., Akcan, U., Bilgic Gazioglu, S., Tuzun, E., Riff, R., Naamani, O., Douvdevani, A., Takegawa, R., Yoshida, H., Hirose, T., Yamamoto, N., Hagiya, H., Ojima, M., Akeda, Y., Tasaki, O., Tomono, K., Shimazu, T., Ono, S., Kubo, T., Suda, S., Ueno, T., Ikeda, T., Ogura, H., Takahashi, H., Kang, J., Nakamura, Y., Kojima, T., Izutani, Y., Taniguchi, T., O, M., Dinter, C., Lotz, J., Eilers, B., Wissmann, C., Lott, R., Meili, M. M., Schuetz, P. S., Hawa, H., Sharshir, M., Aburageila, M., Salahuddin, N., Chantziara, V., Georgiou, S., Tsimogianni, A., Alexandropoulos, P., Vassi, A., Lagiou, F., Valta, M., Micha, G., Chinou, E., Michaloudis, G., Kodaira, A., Imaizumi, H., De la Torre-Prados, M. V., Garcia-De la Torre, A., Enguix-Armada, A., Puerto-Morlan, A., Perez-Valero, V., Garcia-Alcantara, A., Bolton, N., Dudziak, J., Bonney, S., Tridente, A., Nee, P., Nicolaes, G., Wiewel, M., Schultz, M., Wildhagen, K., Horn, J., Schrijver, R., Van der Poll, T., Reutelingsperger, C., Pillai, S., Davies, G., Mills, G., Aubrey, R., Morris, K., Williams, P., Evans, P., Gayat, E. G., Struck, J., Cariou, A., Deye, N., Guidet, B., Jabert, S., Launay, J., Legrand, M., Léone, M., Resche-Rigon, M., Vicaut, E., Vieillard-Baron, A., Mebazaa, A., Arnold, R., Capan, M., Linder, A., Akesson, P., Popescu, M., Tomescu, D., Sprung, C. L., Calderon Morales, R., Munteanu, G., Orenbuch-Harroch, E., Levin, P., Kasdan, H., Reiter, A., Volker, T., Himmel, Y., Cohen, Y., Meissonnier, J., Girard, L., Rebeaud, F., Herrmann, I., Delwarde, B., Peronnet, E., Cerrato, E., Venet, F., Lepape, A., Rimmelé, T., Monneret, G., Textoris, J., Beloborodova, N., Moroz, V., Osipov, A., Bedova, A., Sarshor, Y., Pautova, A., Sergeev, A., Chernevskaya, E., Odermatt, J., Bolliger, R., Hersberger, L., Ottiger, M., Christ-Crain, M., Mueller, B., Schuetz, P., Sharma, N. K., Tashima, A. K., Brunialti, M. K., Machado, F. R., Assuncao, M., Rigato, O., Salomao, R., Cajander, S. C., Rasmussen, G., Tina, E., Söderquist, B., Källman, J., Strålin, K., Lange, A. L., Sundén-Cullberg, J. S., Magnuson, A. M., Hultgren, O. H., Van der Geest, P., Mohseni, M., Linssen, J., De Jonge, R., Duran, S., Groeneveld, J., Miller, R., Lopansri, B. K., McHugh, L. C., Seldon, A., Burke, J. P., Johnston, J., Reece-Anthony, R., Bond, A., Molokhia, A., Mcgrath, C., Nsutebu, E., Bank Pedersen, P., Pilsgaard Henriksen, D., Mikkelsen, S., Touborg Lassen, A., Tincu, R., Cobilinschi, C., Ghiorghiu, Z., Macovei, R., Wiewel, M. A., Harmon, M. B., Van Vught, L. A., Scicluna, B. P., Hoogendijk, A. J., Zwinderman, A. H., Cremer, O. L., Bonten, M. J., Schultz, M. J., Juffermans, N. P., Wiersinga, W. J., Eren, G., Tekdos, Y., Dogan, M., Acicbe, O., Kaya, E., Hergunsel, O., Alsolamy, S., Ghamdi, G., Alswaidan, L., Alharbi, S., Alenezi, F., Arabi, Y., Heaton, J., Boyce, A., Nolan, L., Dukoff-Gordon, A., Dean, A., Mann Ben Yehudah, T., Fleischmann, C., Thomas-Rueddel, D., Haas, C., Dennler, U., Reinhart, K., Suntornlohanakul, O., Khwannimit, B., Breckenridge, F., Puxty, A., Szturz, P., Folwarzcny, P., Svancara, J., Kula, R., Sevcik, P., Caneva, L., Casazza, A., Bellazzi, E., Marra, S., Pagani, L., Vetere, M., Vanzino, R., Ciprandi, D., Preda, R., Boschi, R., Carnevale, L., Lopez, V., Aguilar Arzapalo, M., Barradas, L., Escalante, A., Gongora, J., Cetina, M., Adamik, B, Jakubczyk, D, Kübler, A, Radford, A., Lee, T., Singer, J., Boyd, J., Fineberg, D., Williams, M., Russell, J., Scarlatescu, E., Droc, G., Arama, S., Müller, M., Straat, M., Zeerleder, S. S., Fuchs, C. F., Scheer, C. S., Wauschkuhn, S. W., Vollmer, M. V., Meissner, K. M., Kuhn, S. K., Hahnenkamp, K. H., Rehberg, S. R., Gründling, M. G., Hamaguchi, S., Gómez-Sánchez, E., Heredia-Rodríguez, M., Álvarez-Fuente, E., Lorenzo-López, M., Gómez-Pesquera, E., Aragón-Camino, M., Liu-Zhu, P., Sánchez-López, A., Hernández-Lozano, A., Peláez-Jareño, M. T., Tamayo, E., Thomas-Rüddel, D. O., Adora, V., Kar, A., Chakraborty, A., Roy, S., Bandyopadhyay, A., Das, M., BenYehudah, G., Salim, M., Kumar, N., Arabi, L., Burger, T., Lephart, P., Toth-martin, E., Valencia, C., Hammami, N., Blot, S., Vincent, J. L., Lambert, M. L., Brunke, J., Riemann, T., Roschke, I., Nimitvilai, S., Jintanapramote, K., Jarupongprapa, S., Adukauskiene, D., Valanciene, D., Bose, G., Lostarakos, V., Carr, B., Khedher, S., Maaoui, A., Ezzamouri, A., Salem, M., Chen, J., Cranendonk, D. R., Day, M., Penrice, G., Roy, K., Robertson, P., Godbole, G., Jones, B., Booth, M., Donaldson, L., Kawano, Y., Ishikura, H., Al-Dorzi, H., Almutairi, M., Alhamadi, B., Crizaldo Toledo, A., Khan, R., Al Raiy, B., Talaie, H., Van Oers, J. A., Harts, A., Nieuwkoop, E., Vos, P., Boussarsar, Y., Boutouta, F., Kamoun, S., Mezghani, I., Koubaji, S., Ben Souissi, A., Riahi, A., Mebazaa, M. S., Giamarellos-Bourboulis, E., Tziolos, N., Routsi, C., Katsenos, C., Tsangaris, I., Pneumatikos, I., Vlachogiannis, G., Theodorou, V., Prekates, A., Antypa, E., Koulouras, V., Kapravelos, N., Gogos, C., Antoniadou, E., Mandragos, K., Armaganidis, A., Robles Caballero, A. R., Civantos, B., Figueira, J. C., López, J., Silva-Pinto, A., Ceia, F., Sarmento, A., Santos, L., Almekhlafi, G., Sakr, Y., Baharoon, S., Aldawood, A., Matroud, A., Alchin, J., Al Johani, S., Balkhy, H., Yousif, S. Y., Alotabi, B. O., Alsaawi, A. S., Ang, J., Curran, M. D., Enoch, D., Navapurkar, V., Morris, A., Sharvill, R., Astin, J., Patel, J., Kruger, C., O’Neal, J., Rhodes, H., Jancik, J., François, B., Laterre, P. F., Eggimann, P., Torres, A., Sánchez, M., Dequin, P. F., Bassi, G. L., Chastre, J., Jafri, H. S., Ben Romdhane, M., Douira, Z., Bousselmi, M., Vakalos, A., Avramidis, V., Craven, T. H., Wojcik, G., Kefala, K., McCoubrey, J., Reilly, J., Paterson, R., Inverarity, D., Laurenson, I., Walsh, T. S., Mongodi, S., Bouhemad, B., Orlando, A., Stella, A., Via, G., Iotti, G., Braschi, A., Mojoli, F., Haliloglu, M., Bilgili, B., Kasapoglu, U., Sayan, I., Süzer Aslan, M., Yalcın, A., Cinel, I., Ellis, H. E., Bauchmuller, K., Miller, D., Temple, A., Luyt, C. E., Singer, M., Nassar, Y., Ayad, M. S., Trifi, A., Abdellatif, S., Daly, F., Nasri, R., Ben Lakhal, S., Gul, F., Kuzovlev, A., Shabanov, A., Polovnikov, S., Kadrichu, N., Dang, T., Corkery, K., Challoner, P., Bassi, G. Li, Aguilera, E., Chiurazzi, C., Travierso, C., Motos, A., Fernandez, L., Amaro, R., Senussi, T., Idone, F., Bobi, J., Rigol, M., Hodiamont, C. J., Janssen, J. M., Bouman, C. S., Mathôt, R. A., De Jong, M. D., Van Hest, R. M., Payne, L., Fraser, G. L., Tudor, B., Lahner, M., Roth, G., Krenn, C., Jault, P., Gabard, J., Leclerc, T., Jennes, S., Que, Y., Rousseau, A., Ravat, F., Eissa, A., Al-Harbi, S., Aldabbagh, T., Abdellatif., S., Paramba, F., Purayil, N., Naushad, V., Mohammad, O., Negi, V., Chandra, P., Kleinsasser, A., Witrz, M. R., Buchner-Doeven, J. F., Tuip-de Boer, A. M., Goslings, J. C., Van Hezel, M., Boing, A, Van Bruggen, R, Juffermans, N, Markopoulou, D., Venetsanou, K., Kaldis, V., Koutete, D., Chroni, D., Alamanos, I., Koch, L., Walter, E., Maekawa, K., Hayakawa, M., Kushimoto, S., Shiraishi, A., Kato, H., Sasaki, J., Matauoka, T., Uejima, T., Morimura, N., Hagiwara, A., Takeda, M., Tarabrin, O., Shcherbakow, S., Gavrychenko, D., Mazurenko, G., Ivanova, V., Chystikov, O., Plourde, C., Lessard, J., Chauny, J., Daoust, R., Kropman, L., In het Panhuis, L., Konings, J., Huskens, D., Schurgers, E., Roest, M., De Laat, B., Lance, M., Durila, M., Lukas, P., Astraverkhava, M., Jonas, J., Budnik, I., Shenkman, B., Hayami, H., Koide, Y., Goto, T., Iqbal, R., Alhamdi, Y., Venugopal, N., Abrams, S., Downey, C., Toh, C. H., Welters, I. D., Bombay, V. B., Chauny, J. M., Daoust, R. D., Lessard, J. L., Marquis, M. M., Paquet, J. P., Siemens, K., Sangaran, D., Hunt, B. J., Durward, A., Nyman, A., Murdoch, I. A., Tibby, S. M., Ampatzidou, F., Moisidou, D., Dalampini, E., Nastou, M., Vasilarou, E., Kalaizi, V., Chatzikostenoglou, H., Drossos, G., Spadaro, S., Fogagnolo, A., Fiore, T., Schiavi, A., Fontana, V., Taccone, F., Volta, C., Chochliourou, E., Volakli, E., Violaki, A., Samkinidou, E., Evlavis, G., Panagiotidou, V., Sdougka, M., Mothukuri, R., Battle, C., Guy, K., Wijesuriya, J., Keogh, S., Docherty, A., O’Donnell, R., Brunskill, S., Trivella, M., Doree, C., Holst, L., Parker, M., Gregersen, M., Almeida, J., Walsh, T., Stanworth, S., Moravcova, S., Mansell, J., Rogers, A., Smith, R. A., Hamilton-Davies, C., Omar, A., Allam, M., Bilala, O., Kindawi, A., Ewila, H., Malamas, A., Ferreira, G., Caldas, J., Fukushima, J., Osawa, E. A., Arita, E., Camara, L., Zeferino, S., Jardim, J., Gaioto, F., Dallan, L., Jatene, F. B., Kalil Filho, R., Galas, F., Hajjar, L. A., Mitaka, C., Ohnuma, T., Murayama, T., Kunimoto, F., Nagashima, M., Takei, T., Tomita, M., Mahmoud, K., Hanoura, S., Sudarsanan, S., Sivadasan, P., Othamn, H., Shouman, Y., Singh, R., Al Khulaifi, A., Mandel, I., Mikheev, S., Suhodolo, I., Kiselev, V., Svirko, Y., Podoksenov, Y., Jenkins, S. A., Griffin, R., Tovar Doncel, M. S., Lima, A., Aldecoa, C., Ince, C., Taha, A., Shafie, A., Mostafa, M., Syed, N., Hon, H., Righetti, F., Colombaroli, E., Castellano, G., Hravnak, M., Chen, L. C., Dubrawski, A. D., Clermont, G. C., Pinsky, M. R., Gonzalez, S., Macias, D., Acosta, J., Jimenez, P., Loza, A., Lesmes, A., Lucena, F., Leon, C., Bastide, M., Richecoeur, J., Frenoy, E., Lemaire, C., Sauneuf, B., Tamion, F., Nseir, S., Du Cheyron, D., Dupont, H., Maizel, J., Shaban, M., Kolko, R., AbuRageila, M., AlHussain, A., Mercado, P., Kontar, L., Titeca, D., Brazier, F., Riviere, A., Joris, M., Soupison, T., De Cagny, B., Slama, M., Wagner, J., Körner, A., Kubik, M., Kluge, S., Reuter, D., Saugel, B., Tran, T., De Bels, D., Cudia, A., Strachinaru, M., Ghottignies, P., Devriendt, J., Pierrakos, C., Martínez González, Ó., Blancas, R., Luján, J., Ballesteros, D., Martínez Díaz, C., Núñez, A., Martín Parra, C., López Matamala, B., Alonso Fernández, M., Chana, M., Huber, W., Eckmann, M., Elkmann, F., Gruber, A., Klein, I., Schmid, R. M., Lahmer, T., Moller, P. W., Sondergaard, S., Jakob, S. M., Takala, J., Berger, D., Bastoni, D., Aya, H., Toscani, L., Pigozzi, L., Rhodes, A., Cecconi, M., Ostrowska, C., Abbas, A., Mellinghoff, J., Ryan, C., Dawson, D., Cronhjort, M., Wall, O., Nyberg, E., Zeng, R., Svensen, C., Mårtensson, J., Joelsson-Alm, E., Parenti, N., Palazzi, C., Amidei, L. A., Borrelli, F. B., Campanale, S. C., Tagliazucchi, F. T., Sedoni, G. S., Lucchesi, D. L., Carella, E. C., Luciani, A. L, Mackovic, M., Maric, N., Bakula, M., Grounds, R. M., Fletcher, N., Avard, B., Zhang, P., Mezidi, M., Charbit, J., Ould-Chikh, M., Deras, P., Maury, C., Martinez, O., Capdevila, X., Hou, P., Linde-Zwirble, W. Z., Douglas, I. D., Shapiro, N. S., Ben Aicha, Y., Laribi, B., Jeribi, B., Pereira, C., Marinho, R., Antunes, R., Marinho, A., Crivits, M., Raes, M., Decruyenaere, J., Hoste, E., Bagin, V., Rudnov, V., Savitsky, A., Astafyeva, M., Korobko, I., Vein, V., Kampmeier, T., Arnemann, P., Hessler, M., Wald, A., Bockbreder, K., Morelli, A., Van Aken, H., Rehberg, S., Ertmer, C., Reddy, S., Bailey, M., Beasley, R., Bellomo, R., Mackle, D., Psirides, A., Young, P., Venkatesh, H., Ramachandran, S., Basu, A., Nair, H., Egan, S., Bates, J., Oliveira, S., Rangel Neto, N. R., Reis, F. Q., Lee, C. P., Lin, X. L., Choong, C., Eu, K. M., Sim, W. Y., Tee, K. S., Pau, J., Abisheganaden, J., Maas, K., De Geus, H., Lafuente, E., Moura, J., Doris, T. E., Monkhouse, D., Shipley, T., Kardasz, S., Gonzalez, I, Stads, S., Groeneveld, A. 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H., Dakova, S., Ramsheva, Z., Ramshev, K., Marudi, A, Baroni, S, Gaspari, A, Bertellini, E, Ozcan, P. E., Sencer, S., Ulusoy, C., Fallenius, M., Skrifvars, M. B., Reinikainen, M., Bendel, S., Raj, R., Abu-Habsa, M., Hymers, C., Borowska, A., Sivadhas, H., Sahiba, S., Perkins, S., Rubio, J., Rubio, J. A., Sierra, R., English, S., Chasse, M., Turgeon, A., Lauzier, F., Griesdale, D., Garland, A., Fergusson, D., Zarychanski, R., Tinmouth, A., Van Walraven, C., Montroy, K., Ziegler, J., Dupont Chouinard, R., Carignan, R., Dhaliwal, A., Lum, C., Sinclair, J., Pagliarello, G., McIntyre, L., Groza, T., Moreau, N., Castanares-Zapatero, D., Hantson, P., Carbonara, M., Ortolano, F., Zoerle, T., Magnoni, S., Pifferi, S., Conte, V., Stocchetti, N., Carteron, L., Suys, T., Patet, C., Quintard, H., Oddo, M., Spatenkova, V., Pokorna, E., Suchomel, P., Ebert, N., Bylinski, T., Hawthorne, C., Shaw, M., Piper, I., Kinsella, J., Kink, A. K., Rätsep, I. 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N., Helme, E., Hadfield, S., Shak, J., Senver, C., Howard-Griffin, R., Wacharasint, P., Fuengfoo, P., Sukcharoen, N., Rangsin, R., Sbiti-Rohr, D., Na, H., Song, S., Lee, S., Jeong, E., Lee, K., Zoumpelouli, E., Volakli, E. A, Chrysohoidou, V., Charisopoulou, K., Kotzapanagiotou, E., Manavidou, K., Stathi, Z., AlGhamdi, B., Marashly, Q., Zaza, K., Khurshid, M., Ali, Z., Malgapo, M., Jamil, M., Shafquat, A., Shoukri, M., Hijazi, M., Rocha, F. A., Ebecken, K., Rabello, L. S., Lima, M. F., Hatum, R., De Marco, F. V., Alves, A., Pinto, J. E., Godoy, M., Brasil, P. E., Bozza, F. A., Salluh, J. I., Soares, M., Krinsley, J., Kang, G., Perry, J., Hines, H., Wilkinson, K. M., Tordoff, C., Sloan, B., Bellamy, M. C., Moreira, E., Verga, F., Barbato, M., Burghi, G., Soares, M, Silva, U. V., Torelly, A. P., Kahn, J. M., Angus, D. C., Knibel, M. F., Marshall, R., Gilpin, T., Mota, D., Loureiro, B., Dias, J., Afonso, O., Coelho, F., Martins, A., Faria, F., Al Orainni, H., AlEid, F., Tlaygeh, H., Itani, A., Hejazi, A., Messika, J., Ricard, J. D., Guillo, S., Pasquet, B., Dubief, E., Tubach, F., James, K., Temblett, P., Davies, L., Lynch, C., Pereira, S., Cavaco, S., Fernandes, J., Moreira, I., Almeida, E., Seabra Pereira, F., Malheiro, M., Cardoso, F., Aragão, I., Cardoso, T., Fister, M., Muraray Govind, P., Brahmananda Reddy, N., Pratheema, R., Arul, E. D., Devachandran, J., Chin-Yee, N., D’Egidio, G., Thavorn, K., Kyeremanteng, K., Murchison, A. G., Swalwell, K., Mandeville, J., Stott, D., Guerreiro, I., Goossens, C., Marques, M. B., Derde, S., Vander Perre, S., Dufour, T., Thiessen, S. E., Güiza, F., Janssens, T., Hermans, G., Vanhorebeek, I., De Bock, K., Van den Berghe, G., Langouche, L., Miles, B., Madden, S., Weiler, M., Marques, P., Rodrigues, C., Boeira, M., Brenner, K., Leães, C., Machado, A., Townsend, R., Andrade, J., Kishore, R., Fenlon, C., Fiks, T., Ruijter, A., Te Raa, M., Spronk, P., Docherty, P., Dickson, J., Moltchanova, E., Scarrot, C., Hall, T., Ngu, W. C., Jack, J. M., Pavli, A., Gee, X., Akin Korhan, E., Shirazy, M., Fayed, A., Gupta, S., Kaushal, A., Dewan, S., Varma, A., Ghosh, E., Yang, L., Eshelman, L., Lord, B., Carlson, E., Broderick, R., Ramos, J., Forte, D., Yang, F., Feeney, J., Wilkinson, K., Shuker, K., Faulds, M., Bryden, D., England, L., Shuker, K, Tridente, A, Faulds, M, Matheson, A, Gaynor, J., Bryden, D, Peroni, B., Daglius-Dias, R., Miranda, L., Cohen, C., Carvalho, C., Velasco, I., Kelly, J. M., Neill, A., Rubenfeld, G., Masson, N., Min, A., Boezeman, E., Hofhuis, J., Hovingh, A., De Vries, R., Cabral-Campello, G., Van Mol, M., Nijkamp, M., Kompanje, E., Ostrowski, P., Kiss, K., Köves, B., Csernus, V., Molnár, Z., Hoydonckx, Y., Vanwing, S., Medo, V., Galvez, R., Miranda, J. P., Stone, C., Wigmore, T., Arunan, Y., Wheeler, A., Wong, Y., Poi, C., Gu, C., Molmy, P., Van Grunderbeeck, N., Nigeon, O., Lemyze, M., Thevenin, D., Mallat, J., Correa, M., Carvalho, R. T., Fernandez, A., McBride, C., Koonthalloor, E., Walsh, C., Webber, A., Ashe, M., Smith, K., Volakli, E. A., Dimitriadou, M., Mantzafleri, P., Vrani, O., Arbouti, A., Varsami, T., Bollen, J. A., Van Smaalen, T. C., De Jongh, W. C., Ten Hoopen, M. M., Ysebaert, D., Van Heurn, L. W., Van Mook, W. N., Roze des Ordons, A., Couillard, P., Doig, C., Van Keer, R. V., Deschepper, R. D., Francke, A. F., Huyghens, L. H., Bilsen, J. B., Nyamaizi, B., Dalrymple, C., Dobru, A., Marrinan, E., Ankuli, A., Struthers, R., Crawford, R., Mactavish, P., Morelli, P., Degiovanangelo, M., Lemos, F., MArtinez, V., Cabrera, J., Rutten, A., Van Ieperen, S., De Geer, S., Van Vugt, M., Der Kinderen, E., Giannini, A., Miccinesi, G, Marchesi, T, and Prandi, E
- Subjects
Protocol (science) ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,French ,030208 emergency & critical care medicine ,Compression (physics) ,Critical Care and Intensive Care Medicine ,Meeting Abstracts ,language.human_language ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Ventilation (architecture) ,Emergency medicine ,language ,Medicine ,030212 general & internal medicine ,Cardiopulmonary resuscitation ,business - Abstract
Table of contents P001 - Sepsis impairs the capillary response within hypoxic capillaries and decreases erythrocyte oxygen-dependent ATP efflux R. M. Bateman, M. D. Sharpe, J. E. Jagger, C. G. Ellis P002 - Lower serum immunoglobulin G2 level does not predispose to severe flu. J. Solé-Violán, M. López-Rodríguez, E. Herrera-Ramos, J. Ruíz-Hernández, L. Borderías, J. Horcajada, N. González-Quevedo, O. Rajas, M. Briones, F. Rodríguez de Castro, C. Rodríguez Gallego P003 - Brain protective effects of intravenous immunoglobulin through inhibition of complement activation and apoptosis in a rat model of sepsis F. Esen, G. Orhun, P. Ergin Ozcan, E. Senturk, C. Ugur Yilmaz, N. Orhan, N. Arican, M. Kaya, M. Kucukerden, M. Giris, U. Akcan, S. Bilgic Gazioglu, E. Tuzun P004 - Adenosine a1 receptor dysfunction is associated with leukopenia: A possible mechanism for sepsis-induced leukopenia R. Riff, O. Naamani, A. Douvdevani P005 - Analysis of neutrophil by hyper spectral imaging - A preliminary report R. Takegawa, H. Yoshida, T. Hirose, N. Yamamoto, H. Hagiya, M. Ojima, Y. Akeda, O. Tasaki, K. Tomono, T. Shimazu P006 - Chemiluminescent intensity assessed by eaa predicts the incidence of postoperative infectious complications following gastrointestinal surgery S. Ono, T. Kubo, S. Suda, T. Ueno, T. Ikeda P007 - Serial change of c1 inhibitor in patients with sepsis – A prospective observational study T. Hirose, H. Ogura, H. Takahashi, M. Ojima, J. Kang, Y. Nakamura, T. Kojima, T. Shimazu P008 - Comparison of bacteremia and sepsis on sepsis related biomarkers T. Ikeda, S. Suda, Y. Izutani, T. Ueno, S. Ono P009 - The changes of procalcitonin levels in critical patients with abdominal septic shock during blood purification T. Taniguchi, M. O P010 - Validation of a new sensitive point of care device for rapid measurement of procalcitonin C. Dinter, J. Lotz, B. Eilers, C. Wissmann, R. Lott P011 - Infection biomarkers in primary care patients with acute respiratory tract infections – Comparison of procalcitonin and C-reactive protein M. M. Meili, P. S. Schuetz P012 - Do we need a lower procalcitonin cut off? H. Hawa, M. Sharshir, M. Aburageila, N. Salahuddin P013 - The predictive role of C-reactive protein and procalcitonin biomarkers in central nervous system infections with extensively drug resistant bacteria V. Chantziara, S. Georgiou, A. Tsimogianni, P. Alexandropoulos, A. Vassi, F. Lagiou, M. Valta, G. Micha, E. Chinou, G. Michaloudis P014 - Changes in endotoxin activity assay and procalcitonin levels after direct hemoperfusion with polymyxin-b immobilized fiber A. Kodaira, T. Ikeda, S. Ono, T. Ueno, S. Suda, Y. Izutani, H. Imaizumi P015 - Diagnostic usefullness of combination biomarkers on ICU admission M. V. De la Torre-Prados, A. Garcia-De la Torre, A. Enguix-Armada, A. Puerto-Morlan, V. Perez-Valero, A. Garcia-Alcantara P016 - Platelet function analysis utilising the PFA-100 does not predict infection, bacteraemia, sepsis or outcome in critically ill patients N. Bolton, J. Dudziak, S. Bonney, A. Tridente, P. Nee P017 - Extracellular histone H3 levels are inversely correlated with antithrombin levels and platelet counts and are associated with mortality in sepsis patients G. Nicolaes, M. Wiewel, M. Schultz, K. Wildhagen, J. Horn, R. Schrijver, T. Van der Poll, C. Reutelingsperger P018 - Il-8: is this a more reliable biomarker for sepsis severity than CRP, Procalcitonin, E-selectin, IL-6 and TNF-[alpha] S. Pillai, G. Davies, G. Mills, R. Aubrey, K. Morris, P. Williams, P. Evans P019 - Relation between adrenomedullin and short-term outcome in ICU patients: Results from the frog ICU study E. G. Gayat, J. Struck, A. Cariou, N. Deye, B. Guidet, S. Jabert, J. Launay, M. Legrand, M. Léone, M. Resche-Rigon, E. Vicaut, A. Vieillard-Baron, A. Mebazaa P020 - Impact of disease severity assessment on performance of heparin-binding protein for the prediction of septic shock R. Arnold, M. Capan, A. Linder, P. Akesson P021 - Kinetics and prognostic value of presepsin (sCD14) in septic patients. A pilot study M. Popescu, D. Tomescu P022 - Comparison of CD64 levels performed by the facs and accellix systems C. L. Sprung, R. Calderon Morales, G. Munteanu, E. Orenbuch-Harroch, P. Levin, H. Kasdan, A. Reiter, T. Volker, Y. Himmel, Y. Cohen, J. Meissonnier P023 - Diagnosing sepsis in 5 minutes: Nanofluidic technology study with pancreatic-stone protein (PSP/ reg) L. Girard, F. Rebeaud P024 - How nanotechnology-based approaches could contribute to sepsis prevention, diagnosis and treatment I. Herrmann P025 - Il7r transcriptional expression analysis during septic shock B. Delwarde, E. Peronnet, E. Cerrato, F. Venet, A. Lepape, T. Rimmelé, G. Monneret, J. Textoris P026 - Disbalance of microbial metabolites of aromatic acids affects the severity in critically ill patients N. Beloborodova, V. Moroz, A. Osipov, A. Bedova, Y. Sarshor, A. Pautova, A. Sergeev, E. Chernevskaya P027 - Copeptin predicts 10-year all-cause mortality in community patients J. Odermatt, R. Bolliger, L. Hersberger, M. Ottiger, M. Christ-Crain, B. Mueller, P. Schuetz P028 - Identification of differential proteomic response in septic patients secondary to community and hospital acquired pneumonia N. K. Sharma, A. K. Tashima, M. K. Brunialti, F. R. Machado, M. Assuncao, O. Rigato, R. Salomao P029 - Monocyte HLA-DR expression in community-acquired bacteremic sepsis - dynamics associated to aetiology and prediction of secondary sepsis S. C. Cajander, G. Rasmussen, E. Tina, B. Söderquist, J. Källman, K. Strålin P030 - Soluble B- and T-lymphocyte attenuator: A possible prognostic marker in sepsis A. L. Lange, J. S. Sundén-Cullberg, A. M. Magnuson, O. H. Hultgren P031 - Fractal dimension: A new biomarker for quantifying clot microstructure in patients across the sepsis spectrum G. Davies, S. Pillai, G. Mills, R. Aubrey, K. Morris, P. Williams, P. Evans P032 - Comparison between the new biomarker for coagulation, clot microstructure (Df) with rotational thromboelastometry (ROTEM) in patients across the sepsis spectrum S. Pillai, G. Davies, G. Mills, R. Aubrey, K. Morris, P. Williams, P. Evans P033 - Changes in fibrinolysis across the sepsis spectrum: The use of rotational thromboelastometry (ROTEM) lysis index (LI60) and D-Dimer concentration S. Pillai, G. Davies, G. Mills, R. Aubrey, K. Morris, P. Williams, P. Evans P034 - The intensive care infection score – a promising marker for the prediction of infection and its severity. P. Van der Geest, M. Mohseni, J. Linssen, R. De Jonge, S. Duran, J. Groeneveld P035 - Challenges in the clinical diagnosis of sepsis R. Miller III, B. K. Lopansri, L. C. McHugh, A. Seldon, J. P. Burke P036 - Does zero heat flux thermometry more accurately identify sepsis on intensive care? J. Johnston, R. Reece-Anthony, A. Bond, A. Molokhia P037 - Advancing quality (AQ) sepsis programme: Improving early identification & treatment of sepsis in North West England. C. Mcgrath, E. Nsutebu P038 - Prehospital transport of acute septic patients P. Bank Pedersen, D. Pilsgaard Henriksen, S. Mikkelsen, A. Touborg Lassen P039 - Vasodilatory plant extracts gel as an alternative treatment for fever in critically ill patients R. Tincu, C. Cobilinschi, D. Tomescu, Z. Ghiorghiu, R. Macovei P040 - Host response and outcome of hypothermic sepsis M. A. Wiewel, M. B. Harmon, L. A. Van Vught, B. P. Scicluna, A. J. Hoogendijk, J. Horn, A. H. Zwinderman, O. L. Cremer, M. J. Bonten, M. J. Schultz, T. Van der Poll, N. P. Juffermans, W. J. Wiersinga P041 - Septic shock alert over SIRS criteria has an impact on outcome but needs to be revised G. Eren, Y Tekdos, M. Dogan, O. Acicbe, E. Kaya, O. Hergunsel P042 - Association between previous prescription of βblockers and mortality rate among septic patients: A retrospective observational study S. Alsolamy, G. Ghamdi, L. Alswaidan, S. Alharbi, F. Alenezi, Y. Arabi P043 - Recognition and treatment of sepsis on labour ward– teaching & information resources can improve knowledge J. Heaton, A. Boyce, L. Nolan, J. Johnston, A. Dukoff-Gordon, A. Dean, A. Molokhia P044 - Culture negative sepsis in the ICU – what is unique to this patient population? T. Mann Ben Yehudah P045 - Organ dysfunction in severe sepsis patients identified in administrative data in Germany, 2007-2013 C. Fleischmann, D. Thomas-Rueddel, C. Haas, U. Dennler, K. Reinhart P046 - A comparison of residents’ knowledge regarding; the Surviving Sepsis Campaign 2012 guideline O. Suntornlohanakul, B. Khwannimit P047 - Effectiveness of a septic shock bundle to improve outcomes in the ICU F. Breckenridge, A. Puxty P048 - Dose of norepinephrine in the first 24 hours as a parameter evaluating the effectiveness of treatment in patients with severe sepsis and septic shock P. Szturz, P. Folwarzcny, J. Svancara, R. Kula, P. Sevcik P049 - Norepinephrine or vasopressin + norepinephrine in septic shock. A retrospective series of 39 patients L. Caneva, A. Casazza, E. Bellazzi, S. Marra, L. Pagani, M. Vetere, R. Vanzino, D. Ciprandi, R. Preda, R. Boschi, L. Carnevale P050 - Methylene blue effectiveness as contributory treatment in patients with septic shock V. Lopez, M. Aguilar Arzapalo, L. Barradas, A. Escalante, J. Gongora, M. Cetina P051 - Coagulation disorders in patients with severe sepsis and DIC evaluated with thromboelastometry. B Adamik, D Jakubczyk, A Kübler P052 - Frequency and outcome of early sepsis-associated coagulopathy A. Radford, T. Lee, J. Singer, J. Boyd, D. Fineberg, M. Williams, J. Russell P053 - Assessment of coagulopathy in cancer patients with severe sepsis or septic shock. A case-control pilot study E. Scarlatescu, D. Tomescu, G. Droc, S. Arama P054 - Thromboelastometry in critically ill patients with disseminated intravascular coagulation M. Müller, M. Straat, S. S. Zeerleder, N. P. Juffermans P055 - Cessation of a preexisting chronic antiplatelet therapy is associated with increased mortality rates in severe sepsis and septic shock C. F. Fuchs, C. S. Scheer, S. W. Wauschkuhn, M. V. Vollmer, K. M. Meissner, S. K. Kuhn, K. H. Hahnenkamp, S. R. Rehberg, M. G. Gründling P056 - Neutrophil Extracellular Traps (NETs) production under hypoxic condition N. Yamamoto, M. Ojima, S. Hamaguchi, T. Hirose, Y. Akeda, R. Takegawa, O. Tasaki, T. Shimazu, K. Tomono P057 - Impact of ultraviolet air sterilizer in intensive care unit room, and clinical outcomes of patients E. Gómez-Sánchez, M. Heredia-Rodríguez, E. Álvarez-Fuente, M. Lorenzo-López, E. Gómez-Pesquera, M. Aragón-Camino, P. Liu-Zhu, A. Sánchez-López, A. Hernández-Lozano, M. T. Peláez-Jareño, E. Tamayo P058 - Focus of infection in severe sepsis - comparison of administrative data and prospective cohorts from Germany D. O. Thomas-Rüddel, C. Fleischmann, C. Haas, U. Dennler, K. Reinhart P059 - “Zero CLABSI” – can we get there? Obstacles on the 4 year journey and our strategies to overcome them – experience from an Indian ICU V. Adora, A. Kar, A. Chakraborty, S. Roy, A. Bandyopadhyay, M. Das P060 - Novel molecular techniques to identify central venous catheter (CVC) associated blood stream infections (BSIs) T. Mann Ben Yehudah, G. Ben Yehudah, M. Salim, N. Kumar, L. Arabi, T. Burger, P. Lephart, E. Toth-martin P061 - Zero clabsi” – can we get there? Obstacles on the 4 year journey and our strategies to overcome them – experience from an Indian ICU R. Rao, A. Kar, A. Chakraborty P062 - Prevention of central line-associated bloodstream infections in intensive care units: An international online survey C. Valencia, N. Hammami, S. Blot, J. L. Vincent, M. L. Lambert P063 - 30 days antimicrobial efficacy of non-leaching central venous catheters J. Brunke, T. Riemann, I. Roschke P064 - Efficacy of noble metal alloy-coated catheter in prevention of bacteriuria R. Tincu, C. Cobilinschi, D. Tomescu, Z. Ghiorghiu, R. Macovei P065 - Predicting bacteremic urinary tract infection in community setting: A prospective observational study S. Nimitvilai, K. Jintanapramote, S. Jarupongprapa P066 - Eight-year analysis of acinetobacter spp. monobacteremia in surgical and medical intensive care units at university hospital in Lithuania D. Adukauskiene, D. Valanciene P067 - Group A and group B streptococcal infections in intensive care unit – our experience in a tertiary centre G. Bose, V. Lostarakos, B. Carr P068 - Improved detection of spontaneous bacterial peritonitis by uritop + tm strip test and inoculation of blood culture bottles with ascitic fluid S. Khedher, A. Maaoui, A. Ezzamouri, M. Salem P069 - Increased risk of cellulitis in patients with congestive heart failure: a population based cohort study J. Chen P070 - Outcomes of severe cellulitis and necrotizing fasciitis in the critically ill D. R. Cranendonk, L. A. Van Vught, M. A. Wiewel, O. L. Cremer, J. Horn, M. J. Bonten, M. J. Schultz, T. Van der Poll, W. J. Wiersinga P071 - Botulism outbreak associated with people who inject drugs (PWIDs) in Scotland. M. Day, G. Penrice, K. Roy, P. Robertson, G. Godbole, B. Jones, M. Booth, L. Donaldson P072 - Surveillance of ESBL-producing enterobacteriaceae fecal carriers in the ICU Y. Kawano, H. Ishikura P073 - Prevalence of ESBL and carbapenemase producing uropathogens in a newly opened hospital in south India S. Sreevidya, N. Brahmananda Reddy, P. Muraray Govind, R. Pratheema, J. Devachandran Apollo Speciality Hospital - OMR, Chennai, India P074 - Prevalence, risk factors and outcomes of methicillin-resistant staphylococcus aureus nasal colonization in critically ill patients H. Al-Dorzi, M. Almutairi, B. Alhamadi, A. Crizaldo Toledo, R. Khan, B. Al Raiy, Y. Arabi P075 - Multidrug-resistant Acinetobacter baumannii infection in intensive care unit patients in a hospital with building construction: Is there an association? H. Talaie P076 - Multidrug-resistant organisms in a Dutch ICU J. A. Van Oers, A. Harts, E. Nieuwkoop, P. Vos P077 - Epidemiology and risk factors of ICU acquired infections caused by multidrug-resistant gram negative bacilli Y. Boussarsar, F. Boutouta, S. Kamoun, I. Mezghani, S. Koubaji, A. Ben Souissi, A. Riahi, M. S. Mebazaa P078 - Improving outcomes of severe infections by multidrug-resistant pathogens with polyclonal IgM-enriched immunoglobulins E. Giamarellos-Bourboulis, N. Tziolos, C. Routsi, C. Katsenos, I. Tsangaris, I. Pneumatikos, G. Vlachogiannis, V. Theodorou, A. Prekates, E. Antypa, V. Koulouras, N. Kapravelos, C. Gogos, E. Antoniadou, K. Mandragos, A. Armaganidis P079 - Must change the medical practice in ICU? A. R. Robles Caballero, B. Civantos, J. C. Figueira, J. López P080 - Mediterranean spotted fever in an infectious diseases intensive care unit A. Silva-Pinto, F. Ceia, A. Sarmento, L. Santos P081 - Clinical features and outcomes of patients with Middle East respiratory syndrome requiring admission to a saudi intensive care unit: A retrospective analysis of 31 cases G. Almekhlafi, Y. Sakr P082 - The ICU response to a hospital outbreak of Middle East respiratory syndrome coronavirus infection H. Al-Dorzi, R. Khan, S. Baharoon, A. Aldawood, A. Matroud, J. Alchin, S. Al Johani, H. Balkhy, Y. Arabi P083 - Middle East respiratory syndrome: Surveillance data analysis S. Alsolamy, S. Y. Yousif, B. O. Alotabi, A. S. Alsaawi P085 - Use of Taqman array card molecular diagnostics in severe pneumonia: A case series J. Ang, MD Curran, D. Enoch, V. Navapurkar, A. Conway Morris P086 - ‘BUNS’: An investigation protocol improves the ICU management of pneumonia R. Sharvill, J. Astin P087 - Pneumonia in patients following secondary peritonitis: epidemiological features and impact on mortality M. Heredia-Rodríguez, E. Gómez-Sánchez, M. T. Peláez-Jareño, E. Gómez-Pesquera, M. Lorenzo-López, P. Liu-Zhu, M. Aragón-Camino, A. Hernández-Lozano, A. Sánchez-López, E. Álvarez-Fuente, E. Tamayo P088 - The use of the “CURB-65 score” by emergency room clinicians in a large teaching hospital J. Patel, C. Kruger P089 - Incidence of community acquired pneumonia with viral infection in mechanically ventilated patients in the medical intensive care unit J. O’Neal, H. Rhodes, J. Jancik P090 - The SAATELLITE Study: Prevention of S aureus Nosocomial Pneumonia (NP) with MEDI4893, a Human Monoclonal Antibody (mAb) Against S aureus B. François, P. F. Laterre, P. Eggimann, A. Torres, M. Sánchez, P. F. Dequin, G. L. Bassi, J. Chastre, H. S. Jafri P091 - Risk factors and microbiological profile for nosocomial infections in trauma patients M. Ben Romdhane, Z. Douira, S. Kamoun, M. Bousselmi, A. Ben Souissi, Y. Boussarsar, A. Riahi, M.S. Mebazaa P092 - Correlation between percentages of ventilated patients developed vap and use of antimicrobial agents in ICU patients. A. Vakalos, V. Avramidis P093 - A comparison of two ventilator associated pneumonia surveillance techniques T. H. Craven, G. Wojcik, K. Kefala, J. McCoubrey, J. Reilly, R. Paterson, D. Inverarity, I. Laurenson, T. S. Walsh P094 - Lung ultrasound before and after fiberbronchoscopy - modifications may improve ventilator-associated pneumonia diagnosis S. Mongodi, B. Bouhemad, A. Orlando, A. Stella, G. Via, G. Iotti, A. Braschi, F. Mojoli P095 - Comparing the accuracy of predictors of mortality in ventilator-associated pneumonia M. Haliloglu, B. Bilgili, U. Kasapoglu, I. Sayan, M. Süzer Aslan, A. Yalcın, I. Cinel P096 - Impact of pRBCs transfusion on percentage of ventilated patients developed VAP in ICU patients A. Vakalos, V. Avramidis P097 - The impact of a series of interventions on the rate of ventilator associated pneumonia in a large teaching hospital H. E. Ellis, K. Bauchmuller, D. Miller, A Temple P098 - The EVADE study: Prevention of Nosocomial Pneumonia (NP) caused by P aeruginosa with MEDI3902, a Novel Bispecific Monoclonal Antibody, against P aeruginosa virulence factors J. Chastre, B. François, A. Torres, C. E. Luyt, M. Sánchez, M. Singer, H. S. Jafri P099 - Short-term inhaled colistin adjunctive therapy for ventilator-associated pneumonia Y. Nassar, M. S. Ayad P100 - Effect of aerosolised colistin on weaning from mechanical ventilation A. Trifi, S. Abdellatif, F. Daly, R. Nasri, S. Ben Lakhal P101 - Septic shock is an independent risk factor for colistin-induced severe acute kidney injury: a retrospective cohort study B. Bilgili, M. Haliloglu, F. Gul, I. Cinel P102 - Nosocomial pneumonia - emphasis on inhaled tobramycin A. Kuzovlev, A. Shabanov, S. Polovnikov, V. Moroz P103 - In vitro evaluation of amikacin inhale and commercial nebulizers in a mechanical ventilator N. Kadrichu, T. Dang, K. Corkery, P. Challoner P104 - The effects of nebulized amikacin/fosfomycin and systemic meropenem on severe amikacin-resistant meropenem-susceptible P.aeruginosa pneumonia G. Li Bassi, E. Aguilera, C. Chiurazzi, C. Travierso, A. Motos, L. Fernandez, R. Amaro, T. Senussi, F. Idone, J. Bobi, M. Rigol, A. Torres P105 - Optimization of gentamicin peak concentrations in critically ill patients C. J. Hodiamont, N. P. Juffermans, J. M. Janssen, C. S. Bouman, R. A. Mathôt, M. D. De Jong, R. M. Van Hest P106 - Systematic review of cefepime induced neurotoxicity L. Payne, G. L. Fraser P107 - Unasyn® causes QT prolongation during treatment of intensive care patients B. Tudor, M. Lahner, G. Roth, C. Krenn P108 - Comparative study between teicoplanin and vancomycin in methicillin-resistant staphylococcus aureus (mrsa) infectious of toxicological intensive care unit (ticu) patients – Tehran, Iran H. Talaie P109 - Phage therapy against antimicrobial resistance, design of the first clinical study phagoburn P. Jault, J. Gabard, T. Leclerc, S. Jennes, Y. Que, A. Rousseau, F. Ravat P110 - Antibiotic dosing errors in critically ill patients with severe sepsis or septic shock H. Al-Dorzi, A. Eissa, S. Al-Harbi, T. Aldabbagh, R. Khan, Y. Arabi P111 - Does empiric antifungal therapy improve survival in septic critically ill patients? (immunocompromised excluded) A. Trifi, S. Abdellatif, F. Daly, R. Nasri, S. Ben Lakhal P112 - Neurocysticercosis-Qatar experience F. Paramba, N. Purayil, V. Naushad, O. Mohammad, V. Negi, P. Chandra P113 - Early indicators in acute haemorrhagic shock A. Kleinsasser P114 - Filtering of red blood cells reduces the inflammatory response of pulmonary cells in an in vitro model of mechanical ventilation M. R. Witrz, J. F. Buchner-Doeven, A. M. Tuip-de Boer, J. C. Goslings, N. P. Juffermans P115 - Microparticles from red blood cell transfusion induce a pro-coagulant and pro-inflammatory endothelial cell response M. Van Hezel, M. Straat, A Boing, R Van Bruggen, N Juffermans P116 - The contribution of cytokines on thrombosis development during hospitalization in ICU D. Markopoulou, K. Venetsanou, V. Kaldis, D. Koutete, D. Chroni, I. Alamanos P117 - Prophylactic enoxaparin dosing and adjustment through anti-xa monitoring in an inpatient burn unit L. Koch, J. Jancik, H. Rhodes, E. Walter P118 - Determination of optimal cut-off values of haemoglobin, platelet count and fibrinogen at 24 hours after injury associated with mortality in trauma patients K. Maekawa, M. Hayakawa, S. Kushimoto, A. Shiraishi, H. Kato, J. Sasaki, H. Ogura, T. Matauoka, T. Uejima, N. Morimura, H. Ishikura, A. Hagiwara, M. Takeda P119 - Trauma-induced coagulopathy - prothrombin complex concentrate vs fresh frozen plasma O. Tarabrin, S. Shcherbakow, D. Gavrychenko, G. Mazurenko, V. Ivanova, O. Chystikov P120 - First study to prove the superiority of prothrombin complex concentrates on mortality rate over fresh frozen plasma in patients with acute bleeding C. Plourde, J. Lessard, J. Chauny, R. Daoust P121 - Prothrombin complex concentrate vs fresh frozen plasma in obstetric massive bleeding S. Shcherbakow, O. Tarabrin, D. Gavrychenko, G. Mazurenko, O. Chystikov P122 - Impact of FFP transfusion on VAP in ICU patients A. Vakalos, V. Avramidis P123 - Preoperative platelet function test and the thrombin generation assay are predictive for blood loss after cardiac surgery L. Kropman, L. In het Panhuis, J. Konings, D. Huskens, E. Schurgers, M. Roest, B. De Laat, M. Lance P124 - Rotational thromboelastometry versus standard coagulation tests before surgical interventions M. Durila, P. Lukas, M. Astraverkhava, J. Jonas P125 - Correction of impaired clot quality and stability by fibrinogen and activated prothrombin complex concentrate in a model of severe thrombocytopenia I. Budnik, B. Shenkman P126 - Assessment of point-of-care prothrombin time analyzer as a monitor after cardiopulmonary bypass H. Hayami, Y. Koide, T. Goto P127 - Disseminated intravascular coagulation (dic) is underdiagnosed in critically ill patients: do we need d-dimer measurements? R. Iqbal, Y. Alhamdi, N. Venugopal, S. Abrams, C. Downey, C. H. Toh, I. D. Welters P128 - Validity of the age-adjusted d-dimer cutoff in patients with COPD B. Bombay, J. M. Chauny, R. D. Daoust, J. L. Lessard, M. M. Marquis, J. P. Paquet P129 - A scoping review of strategies for prevention and management of bleeding following paediatric cardiopulmonary bypass surgery K. Siemens, D. Sangaran, B. J. Hunt, A. Durward, A. Nyman, I. A. Murdoch, S. M. Tibby P130 - Nadir hemoglobulin during cardiopulmonary bypass: impact on postoperative morbidity and mortality F. Ampatzidou, D. Moisidou, E. Dalampini, M. Nastou, E. Vasilarou, V. Kalaizi, H. Chatzikostenoglou, G. Drossos P131 - Red blood cell transfusion do not influence the prognostic value of RDW in critically ill patients S. Spadaro, A. Fogagnolo, T. Fiore, A. Schiavi, V. Fontana, F. Taccone, C. Volta P132 - Reasons for admission in the paediatric intensive care unit and the need for blood and blood products transfusions E. Chochliourou, E. Volakli, A. Violaki, E. Samkinidou, G. Evlavis, V. Panagiotidou, M. Sdougka P133 - The implementation of a massive haemorrhage protocol (mhp) for the management of major trauma: a ten year, single-centre study R. Mothukuri, C. Battle, K. Guy, G. Mills, P. Evans P134 - An integrated major haemorrhage protocol for pre-hospital and retrieval medical teams J. Wijesuriya, S. Keogh P135 - The impact of transfusion thresholds on mortality and cardiovascular events in patients with cardiovascular disease (non-cardiac surgery): a systematic review and meta-analysis A. Docherty, R. O’Donnell, S. Brunskill, M. Trivella, C. Doree, L. Holst, M. Parker, M. Gregersen, J. Almeida, T. Walsh, S. Stanworth P136 - The relationship between poor pre-operative immune status and outcome from cardiac surgery is specific to the peri-operative antigenic threat S. Moravcova, J. Mansell, A. Rogers, R. A. Smith, C. Hamilton-Davies P137 - Impact of simple clinical practice guidelines for reducing post-operative atrial fibrillation after cardiac surgery. A. Omar, M. Allam, O. Bilala, A. Kindawi, H. Ewila P138 - Dexamethasone administration during cardiopulmonary bypass has no beneficial effects on elective postoperative cardiac surgery patients F. Ampatzidou, D. Moisidou, M. Nastou, E. Dalampini, A. Malamas, E. Vasilarou, G. Drossos P139 - Intra-aortic balloon counterpulsation in patients undergoing cardiac surgery (IABCS): preliminary results G. Ferreira, J. Caldas, J. Fukushima, E. A. Osawa, E. Arita, L. Camara, S. Zeferino, J. Jardim, F. Gaioto, L. Dallan, F. B. Jatene, R. Kalil Filho, .F Galas, L. A. Hajjar P140 - Effects of low-dose atrial natriuretic peptide infusion on cardiac surgery-associated acute kidney injury C. Mitaka, T. Ohnuma, T. Murayama, F. Kunimoto, M. Nagashima, T. Takei, M. Tomita P141 - Acute kidney injury influence on high sensitive troponin measurements after cardiac surgery A. Omar, K. Mahmoud, S. Hanoura, S. Sudarsanan, P. Sivadasan, H. Othamn, Y. Shouman, R. Singh, A. Al Khulaifi P142 - Complex evaluation of endothelial dysfunction markers for prognosis of outcomes in patients undergoing cardiac surgery I. Mandel, S. Mikheev, I. Suhodolo, V. Kiselev, Y. Svirko, Y. Podoksenov P143 - New-onset atrial fibrillation in intensive care: incidence, management and outcome S. A. Jenkins, R. Griffin P144 - One single spot measurement of the sublingual microcirculation during acute pulmonary hypertension in a pig model of shock M. S. Tovar Doncel, A. Lima, C. Aldecoa, C. Ince P145 - Assessment of levosimendan as a therapeutic option to recruit the microcirculation in cardiogenic shock – initial experience in cardiac ICU A. Taha, A. Shafie, M. Mostafa, N. Syed, H. Hon P146 - Terlipressin vs. norepinephrine in the Potential Multiorgan Donor(PMD) F. Righetti, E. Colombaroli, G. Castellano P147 - Echocardiography in the potential heart donor exposed to substitution hormonotherapy F. Righetti, E. Colombaroli P148 - Machine learning can reduce rate of monitor alarms M. Hravnak, L. C. Chen, A. D. Dubrawski, G. C. Clermont, M. R. Pinsky P149 - Peripherally inserted central catheters placed in the ICU S. Gonzalez, D. Macias, J. Acosta, P. Jimenez, A. Loza, A. Lesmes, F. Lucena, C. Leon P150 - Recordings of abnormal central venous pressure waveform morphology during an episode of pulmonary hypertension in a porcine shock model M. S. Tovar Doncel, C. Ince, C. Aldecoa, A. Lima P151 - Ultrasound guided central venous access technique among French intensivists M. Bastide, J. Richecoeur, E. Frenoy, C. Lemaire, B. Sauneuf, F. Tamion, S. Nseir, D. Du Cheyron, H. Dupont, J. Maizel P152 - Predictive ability of the Pv-aCO2 gap in patients with shock M. Shaban, R. Kolko, N. Salahuddin, M. Sharshir, M. AbuRageila, A. AlHussain P153 - Comparison of echocardiography and pulmonary artery catheter measurements of hemodynamic parameters in critical ill patients P. Mercado, J. Maizel, L. Kontar, D. Titeca, F. Brazier, A. Riviere, M. Joris, T. Soupison, B. De Cagny, M. Slama P154 - The volume clamp method for noninvasive cardiac output measurement in postoperative cardiothoracic surgery patients: a comparison with intermittent pulmonary artery thermodilution J. Wagner, A. Körner, M. Kubik, S. Kluge, D. Reuter, B. Saugel P155 - Hemodynamic monitoring in patients with septic shock (SS) – CPCCO (continuous pulse contour cardiac output) vs. TEE (transesophageal echocardiography) E. Colombaroli, F. Righetti, G. Castellano P156 - Cardiac output measurement with transthoracic echocardiography in critically ill patients: a pragmatic clinical study T. Tran, D. De Bels, A. Cudia, M. Strachinaru, P. Ghottignies, J. Devriendt, C. Pierrakos P157 - Left ventricular outflow tract velocity time integral correlates with stroke volume index in mechanically ventilated patients Ó. Martínez González, R. Blancas, J. Luján, D. Ballesteros, C. Martínez Díaz, A. Núñez, C. Martín Parra, B. López Matamala, M. Alonso Fernández, M. Chana P158 - Transpulmonary thermodilution (TPTD) derived from femoral vs. jugular central venous catheter: validation of a previously published correction formula and a proprietary correction formula for global end-diastolic volume index (GEDVI) W. Huber, M. Eckmann, F. Elkmann, A. Gruber, I. Klein, R. M. Schmid, T. Lahmer P160 - Dynamic arterial elastance calculated with lidcoplus monitor does not predict changes in arterial pressure after a fluid challenge in postsurgical patients D. Bastoni, H. Aya, L. Toscani, L. Pigozzi, A. Rhodes, M. Cecconi P159 - Venous return driving pressure and resistance in acute blood volume changes P. W. Moller, S. Sondergaard, S. M. Jakob, J. Takala, D. Berger P160 - Dynamic arterial elastance calculated with lidcoplus monitor does not predict changes in arterial pressure after a fluid challenge in postsurgical patients D. Bastoni, H. Aya, L. Toscani, L. Pigozzi, A. Rhodes, M. Cecconi P161 - Analysis of duration of post-operative goal-directed therapy protocol C. Ostrowska, H. Aya, A. Abbas, J. Mellinghoff, C. Ryan, D. Dawson, A. Rhodes, M. Cecconi P162 - Hemodynamic optimization – back to square one? M. Cronhjort, O. Wall, E. Nyberg, R. Zeng, C. Svensen, J. Mårtensson, E. Joelsson-Alm P163 - Effectiveness of fluid thoracic content measurement by bioimpedance guiding intravascular volume optimization in patients with septic shock M. Aguilar Arzapalo, L. Barradas, V. Lopez, M. Cetina P164 - A systematic review on the role of internal jugular vein ultrasound measurements in assessment of volume status in critical shock patients N. Parenti, C. Palazzi, L. A. Amidei, F. B. Borrelli, S. C. Campanale, F. T. Tagliazucchi, G. S. Sedoni, D. L. Lucchesi, E. C. Carella, A. L Luciani P165 - Importance of recognizing dehydration in medical Intensive Care Unit M. Mackovic, N. Maric, M. Bakula P166 - Effect of volume for a fluid challenge in septic patients H. Aya, A. Rhodes, R. M. Grounds, N. Fletcher, M. Cecconi P167 - Fluid bolus practices in a large Australian intensive care unit B. Avard, P. Zhang P168 - Liberal late fluid management is associated with longer ventilation duration and worst outcome in severe trauma patients: a retrospective cohort of 294 patients M. Mezidi, J. Charbit, M. Ould-Chikh, P. Deras, C. Maury, O. Martinez, X. Capdevila P169 - Association of fluids and outcomes in emergency department patients hospitalized with community-acquired pneumonia P. Hou, W. Z. Linde-Zwirble, I. D. Douglas, N. S. Shapiro P170 - Association of positive fluid balance with poor outcome in medicosurgical ICU patients A. Ben Souissi, I. Mezghani, Y. Ben Aicha, S. Kamoun, B. Laribi, B. Jeribi, A. Riahi, M. S. Mebazaa P171 - Impact of fluid balance to organ dysfunction in critically ill patients C. Pereira, R. Marinho, R. Antunes, A. Marinho P172 - Volume bolus in ICU patients: do we need to balance our crystalloids? M. Crivits, M. Raes, J. Decruyenaere, E. Hoste P173 - The use of 6 % HES solution do not reduce total fluid requirement in the therapy of patients with burn shock V. Bagin, V. Rudnov, A. Savitsky, M. Astafyeva, I. Korobko, V. Vein P174 - Electron microscopic assessment of acute kidney injury in septic sheep resuscitated with crystalloids or different colloids T. Kampmeier , P. Arnemann, M. Hessler, A. Wald, K. Bockbreder, A. Morelli, H. Van Aken, S. Rehberg, C. Ertmer P175 - Alterations of conjunctival microcirculation in a sheep model of haemorrhagic shock and resuscitation with 0.9 % saline or balanced tetrastarch P. Arnemann, M. Hessler, T. Kampmeier, S. Rehberg, H. Van Aken, C. Ince, C. Ertmer P176 - A single centre nested pilot study investigating the effect of using 0.9 % saline or Plasma-Lyte 148 ® as crystalloid fluid therapy on gastrointestinal feeding intolerance in mechanically ventilated patients receiving nasogastric enteral nutrition S. Reddy, M. Bailey, R. Beasley, R. Bellomo, D. Mackle, A. Psirides, P. 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Abisheganaden P182 - Plasma NGAL and urinary output: potential parameters for early initiation of renal replacement therapy K. Maas, H. De Geus P183 - Renal replacement therapy for critically ill patients: an intermittent continuity E. Lafuente, R. Marinho, J. Moura, R. Antunes, A. Marinho P184 - A survey of practices related to renal replacement therapy in critically ill patients in the north of England. T. E. Doris, D. Monkhouse, T. Shipley, S. Kardasz, I Gonzalez P185 - High initiation creatinine associated with lower 28-day mortality in critically ill patients necessitating continuous renal replacement therapy S. Stads, A. J. Groeneveld P186 - The impact of Karnofsky performance scale on outcomes in acute kidney injury patients receiving renal replacement therapy on the intensive care unit I. Elsayed, N. Ward, A. Tridente, A. Raithatha P187 - Severe hypophosphatemia during citrate-anticoagulated CRRT A. Steuber, C. Pelletier, S. Schroeder, E. Michael, T. Slowinski, D. Kindgen-Milles P188 - Citrate regional anticoagulation for post dilution continuous renal replacement therapy S. Ghabina P189 - Citrate 18 mmol/l improves anticoagulation during RRT with adsorbing filters F. Turani, A. Belli, S. Busatti, G. Barettin, F. Candidi, F. Gargano, R. Barchetta, M. Falco P190 - Calcium gluconate instead of calcium chloride in citrate-anticoagulated CVVHD O. Demirkiran, M. Kosuk, S. Bozbay P191 - Enhanced clearance of interleukin-6 with continuous veno-venous haemodialysis (CVVHD) using Ultraflux EMiC2 vs. Ultraflux AV1000S V. Weber, J. Hartmann, S. Harm, I. Linsberger, T. Eichhorn, G. Valicek, G. Miestinger, C. Hoermann P192 - Removal of bilirubin with a new adsorbent system: in vitro kinetics S. Faenza, D. Ricci, E. Mancini, C. Gemelli, A. Cuoghi, S. Magnani, M. Atti P193 - Case series of patients with severe sepsis and septic shock treated with a new extracorporeal sorbent T. Laddomada, A. Doronzio, B. Balicco P194 - In vitro adsorption of a broad spectrum of inflammatory mediators with CytoSorb® hemoadsorbent polymer beads M. C. Gruda, P. O’Sullivan, V. P. Dan, T. Guliashvili, A. Scheirer, T. D. Golobish, V. J. Capponi, P. P. Chan P195 - Observations in early vs. late use of cytosorb therapy in critically ill patients K. Kogelmann, M. Drüner, D. Jarczak P196 - Oxiris membrane decreases endotoxin during rrt in septic patients with basal EAA > 0,6 F. Turani, A. B. Belli, S. M. Martni, V. C. Cotticelli, F. Mounajergi, R. Barchetta P197 - An observational prospective study on the onset of augmented renal clearance: the first report S. Morimoto, H. Ishikura P198 - An ultrasound- guided algorithm for the management of oliguria in severe sepsis I. Hussain, N. Salahuddin, A. Nadeem, K. Ghorab, K. Maghrabi P199 - Ultrasound in acute kidney injury (aki). First findings of farius, an education-programme in structural ultrasonography S. K. Kloesel, C. Goldfuss, A. Stieglitz, A. S. Stieglitz, L. Krstevska, G. Albuszies P200 - Effectiveness of renal angina index score predicting acute kidney injury on critically ill patients M. Aguilar Arzapalo, L. Barradas, V. Lopez, A. Escalante, G. Jimmy, M. Cetina P201 - Time length below blood pressure thresholds and progression of acute kidney injury in critically ill patients with or without sepsis: a retrospective, exploratory cohort study J. Izawa, T. Iwami, S. Uchino, M. Takinami, T. Kitamura, T. Kawamura P202 - Anaemia does not affect renal recovery in acute kidney injury J. G. Powell-Tuck, S. Crichton, M. Raimundo, L. Camporota, D. Wyncoll, M. Ostermann P203 - Estimated glomerular filtration rate based on serum creatinine: actual practice in Dutch ICU’s A. Hana, H. R. De Geus P204 - Comparison of estimated glomerular filtration rate calculated by mdrd, ckd-epi-serum-creatinine and ckd-epi-cystatin-c in adult critically ill patients H. R. De Geus, A. Hana P205 - Early diagnosis of septic acute kidney injury in medical critical care patients with a urine cell cycle arrest marker: insulin like growth factor binding protein-7 (IGFBP-7) M. Aydogdu, N. Boyaci, S. Yuksel, G. Gursel, A. B. Cayci Sivri P206 - Urinary neutrophil gelatinase-associated lipocalin as early biomarker of severe acute kidney injury in intensive care J. Meza-Márquez, J. Nava-López, R. Carrillo-Esper P207 - Shrunken pore syndrome is associated with a sharp rise in mortality in patients undergoing elective coronary artery bypass grafting A. Dardashti, A. Grubb P208 - The biomarker nephrocheck™ can discriminate the septic shock patients with an akin 1 or 2 acute renal failure who will not progress toward the akin 3 level J. Maizel, M. Wetzstein, D. Titeca, L. Kontar, F. Brazier, B. De Cagny, A. Riviere, T. Soupison, M. Joris, M. 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O’Sullivan, L. Sweeney, R. MacLoughlin P232 - Evaluation of vibrating mesh and jet nebuliser performance at two different attachment setups in line with a humidifier nebuliser system A. O’Sullivan, P. Kelly, L. Sweeney, E. Mukeria, M. Wolny , R. MacLoughlin P233 - Psv-niv versus cpap in the treatment of acute cardiogenic pulmonary edema A. Pagano, F. Numis, G. Vison, L. Saldamarco, T. Russo, G. Porta, F. Paladino P234 - Noninvasive ventilation in patients with haematologic malignancy: a retrospective review C. Bell, J. Liu, J. Debacker, C. Lee, E. Tamberg, V. Campbell, S. Mehta P235 - Use of non-invasive ventilation in infectious diseases besides classical indications A. Silva-Pinto, A. Sarmento, L. Santos P236 - The impact of fragility on noninvasive mechanical ventilation application and results in the ICU Ý. Kara, F. Yýldýrým, A. Zerman, Z. Güllü, N. Boyacý, B. Basarýk Aydogan, Ü. Gaygýsýz, K. Gönderen, G. Arýk, M. Turkoglu, M. Aydogdu, G. Aygencel, Z. Ülger, G. 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Zakynthinos P269 - Cell counts in endobronchial aspirate to assess airway inflammation in ARDS patients: a pilot study S. Spadaro, I. Kozhevnikova, F. Dalla Corte, S. Grasso, P. Casolari, G. Caramori, C. Volta P270 - Epidemiological and clinical profile of patients with acute respiratory distress syndrome in the surgical intensive care unit surgical, hospital JRA, Antananarivo T. Andrianjafiarinoa, T. Randriamandrato, T. Rajaonera P271 - Effect of high PEEP after recruitment maneuver on right ventricular function in ARDS. Is it good for the lung and for the heart? S. El-Dash, ELV Costa, MR Tucci, F Leleu, L Kontar, B. De Cagny, F. Brazier, D. Titeca, G. Bacari-Risal, J. Maizel, M. Amato, M. Slama P272 - Effect of recruitment maneuver on left ventricular systolic strain P. Mercado, J. Maizel, L. Kontar, D. Titeca, F. Brazier, A. Riviere, M. Joris, T. Soupison, B. De Cagny, S. El Dash, M. Slama P273 - Inhaled nitric oxide – is switching supplier cost effective? Remmington, A. 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Varo Pérez P279 - Diarrhea is a risk factor for liver injury and may lead to intestinal failure associated liver disease in critical illness N. Lefel, F. Schaap, D. Bergmans, S. Olde Damink, M. Van de Poll P280 - Bowel care on the intensive care unit: constipation guideline compliance and complications K. Tizard, C. Lister, L. Poole P281 - Malnutrition assessed by phase angle determines outcomes in low risk cardiac surgery patients D. Ringaitiene, D. Gineityte, V. Vicka, I. Norkiene, J. Sipylaite P282 - Preoperative fasting times in an irish hospital A. O’Loughlin, V. Maraj, J. Dowling P283 - Costs and final outcome of early x delayed feeding in a private Brazil ICU M. B. Velasco, D. M. Dalcomune, E. B. Dias, S. L. Fernandes P284 - Can ventilator derived energy expenditure measurements replace indirect calorimetry? T. Oshima, S. Graf, C. Heidegger, L. Genton, V. Karsegard, Y. Dupertuis, C. Pichard P285 - Revisiting the refeeding syndrome: results of a systematic review N. Friedli, Z. Stanga, B. Mueller, P. Schuetz P286 - Compliance with the new protocol for parenteral nutrition in our ICU L. Vandersteen, B. Stessel, S. Evers, A. Van Assche, L. Jamaer, J. Dubois P287 - Nutrition may be another treatment in the intensive care unit where less is more? R. Marinho, H. Castro, J. Moura, J. Valente, P. Martins, P. Casteloes, C. Magalhaes, S. Cabral, M. Santos, B. Oliveira, A. Salgueiro, A. Marinho P288 - Should we provide more protein to critically ill patients? R. Marinho, M. Santos, E. Lafuente, H. Castro, S. Cabral, J. Moura, P. Martins, B. Oliveira, A. Salgueiro, S. Duarte, S. Castro, M. Melo, P. Casteloes, A. Marinho P289 Protein provision in an adult intensive care unit S. Gray P290 - Prevalence and clinical outcomes of vitamin d deficiency in the medical critically ill patients in Songklanagarind hospital K. Maipang, R. Bhurayanontachai P291 - Vitamin d deficiency strongly predicts adverse medical outcome across different medical inpatient populations: results from a prospective study L. G. Grädel, P. Schütz P292 - Omega-3 fatty acids in patients undergoing cardiac surgery: a systematic review and meta-analysis P. Langlois, W. Manzanares P293 - Can 5-hydroxytriptophan prevent post-traumatic stress disorder in critically ill patients? R. Tincu, C. Cobilinschi, D. Tomescu, Z. Ghiorghiu, R. Macovei P294 - Parenteral selenium in the critically ill: an updated systematic review and meta-analysis W. Manzanares, P. Langlois, M. Lemieux, G. Elke, F. Bloos, K. Reinhart, D. Heyland P295 - Probiotics in the critically ill: an updated systematic review and meta-analysis P. Langlois, M. Lemieux, I. Aramendi, D. Heyland, W. Manzanares P296 - Diabetes with hyperglycemic crisis episodes may be associated with higher risk of pancreatic cancer: a population-based cohort study Y. Su P297 - Incidence of hypoglycemia in an intensive care unit depending on insulin protocol R. Marinho, N. Babo, A. Marinho P298 - Severity of the diseases is two-dimensionally correlated to blood glucose, including blood glucose variability, especially in moderately to severely ill patients with glucose intolerance. M. Hoshino, Y. Haraguchi, S. Kajiwara, T. Mitsuhashi, T. Tsubata, M. Aida P299 - A study of glycemic control by subcutaneous glargine injection transition from continuous regular insulin infusion in critically ill patients T. Rattanapraphat, R. Bhurayanontachai, C. Kongkamol, B. Khwannimit P300 - Glycemic control in Portuguese intensive care unit R. Marinho, M. Santos, H. Castro, E. Lafuente, A. Salgueiro, S. Cabral, P. Martins, J. Moura, B. Oliveira, M. Melo, B. Xavier, J. Valente, C. Magalhaes, P. Casteloes, A. Marinho P301 - Impact of hyperglycemia duration on the day of operation on short-term outcome of cardiac surgery patients D. Moisidou, F. Ampatzidou, C. Koutsogiannidis, M. Moschopoulou, G. Drossos P302 - Lactate levels in diabetic ketoacidosis patients at ICU admissions G. Taskin, M. Çakir, AK Güler, A. Taskin, N. Öcal, S. Özer, L. Yamanel P303 - Intensive care implications of merging heart attack centre units in London J. M. Wong, C. Fitton, S. Anwar, S. Stacey P304 - Special characteristics of in-hospital cardiac arrests M. Aggou, B. Fyntanidou, S. Patsatzakis, E. Oloktsidou, K. Lolakos, E. Papapostolou, V. Grosomanidis P305 - Clinical evaluation of ICU-admitted patients who were resuscitated in the general medicine ward S. Suda , T. Ikeda, S. Ono, T. Ueno, Y. Izutani P306 - Serious game evaluation of a one-hour training basic life support session for secondary school students: new tools for future bystanders S. Gaudry, V. Desailly, P. Pasquier, PB Brun, AT Tesnieres, JD Ricard, D. Dreyfuss, A. Mignon P307 - Public and clinical staff perceptions and knowledge of CPR compared to local and national data J. C White, A. Molokhia, A. Dean, A. Stilwell, G. Friedlaender P308 Dispatcher-assisted telephone cardiopulmonary resuscitation using a French-language compression-ventilation pediatric protocol M. Peters, S. Stipulante, A. Delfosse, AF Donneau, A. Ghuysen P309 Dantrolene versus amiodarone for resuscitation – an experimental study C. Feldmann, D. Freitag, W. Dersch, M. Irqsusi, D. Eschbach, T. Steinfeldt, H. Wulf, T. Wiesmann P310 Long term survival and functional neurological outcome in comatose survivors undergoing therapeutic hypothermia N. Kongpolprom, J. Cholkraisuwat P311 Impact of kidney disease on mortality and neurological outcome in out-of-hospital cardiac arrest: a prospective observational study S. Beitland , E. Nakstad, H. Stær-Jensen , T. Drægni , G. Andersen , D. Jacobsen , C. Brunborg, B. Waldum-Grevbo , K. Sunde P312 ICU dependency of patients admitted after primary percutaneous coronary intervention (PPCI) following out of the hospital cardiac arrest K. Hoyland, D. Pandit P313 Prognostic indicators and outcome prediction model for patients with return of spontaneous circulation from cardiopulmonary arrest: comprehensive registry of in-hospital intensive care on OHCA survival (critical) study in Osaka, Japan K. Hayakawa P314 Cerebral oxygen saturation during resuscitation in a porcine model of cardiac arrest E. Oloktsidou, K. Kotzampassi, B. Fyntanidou, S. Patsatzakis, L. Loukipoudi, E. Doumaki, V. Grosomanidis P315 Presumption of cardiopulmonary resuscitation for sustaining cerebral oxidation using regional cerebral saturation of oxygen: observational cohort study (press study) H. Yasuda P316 EEG reactivity in patients after cardiac arrest: a close look at stimuli MM Admiraal, M. Van Assen, MJ Van Putten, M. Tjepkema-Cloostermans, AF Van Rootselaar, J. Horn P317 Prognostic value of neuron-specific enolase after cardiac arrest F. Ragusa, A. Marudi , S. Baroni, A. Gaspari, E. Bertellini P318 Correlation between electroencephalographic findings and serum neuron specific enolase with outcome of post cardiac arrest patients A. Taha, T. Abdullah, S. Abdel Monem P319 Introduction of a targeted temperature management strategy following cardiac arrest in a district general hospital intensive care unit. S. Alcorn, S. McNeill, S. Russell P320 The evolution of cerebral oxygen saturation in post-cardiac arrest patients treated with therapeutic hypothermia W. Eertmans, C. Genbrugge, I. Meex, J. Dens, F. Jans, C. De Deyne P321 Prognostic factors and neurological outcomes of therapeutic hypothermia in comatose survivors from cardiac arrest: 8-year single center experience J. Cholkraisuwat, N. Kongpolprom P322 Adherence to targeted temperature management after out of hospital cardiac arrest B. Avard, R. Burns P323 Implementation of a therapeutic hypothermia protocol for comatose survivors of out-of-hospital cardiac arrest. A. Patarchi, T. Spina P324 Factors associated with ventilator weaning after targeted temperature management for cardiac arrest patients in japan H. Tanaka, N. Otani, S. Ode, S. Ishimatsu P325 Differential activation of c-fos in paraventricular nuclei of the hypothalamus and thalamus of the rat following myocardial infarction J. Cho, J. B. Moon, C. W. Park, T. G. Ohk, M. C. Shin, M. H. Won P326 Monitoring of cTroponin I in patients with acute ischemic stroke - predictor of inhospital mortality S. Dakova, Z. Ramsheva, K. Ramshev P327 Hyperthermic preconditioning severely accelerates neuronal damage in the gerbil ischemic hippocampal dentate gyrus via decreasing sods expressions J. Cho, J. B. Moon, C. W. Park, T. G. Ohk, M. C. Shin P328 Failure in neuroprotection of remote limb ischemic post conditioning in the hippocampus of a gerbil model of transient cerebral ischemia J. Cho, J. B. Moon, C. W. Park, T. G. Ohk, M. C. 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Perkins P335 Timing of endovascular and surgical treatment for aneurysmal subarachnoid haemorrhage: early but not so fast. J. Rubio, J. A. Rubio, R. Sierra P336 Red blood cell transfusion in aneurysmal subarachnoid hemorrhage – the Sahara cohort study S. English, M. Chasse, A. Turgeon, F. Lauzier, D. Griesdale, A. Garland, D. Fergusson, R. Zarychanski, A. Tinmouth, C. Van Walraven, K. Montroy, J. Ziegler, R. Dupont Chouinard, R. Carignan, A. Dhaliwal, C. Lum, J. Sinclair, G. Pagliarello, L. McIntyre P337 - Aneurysmal subarachnoid hemorrhage and anemia: a canadian multi-centre retrospective cohort study S. English, M. Chasse, A. Turgeon, F. Lauzier, D. Griesdale, A. Garland, D. Fergusson, R. Zarychanski, A. Tinmouth, C. Van Walraven, K. Montroy, J. Ziegler, R. Dupont Chouinard, R. Carignan, A. Dhaliwal, C. Lum, J. Sinclair, G. Pagliarello, L. McIntyre P338 - Does the neutrophil-to-lymphocyte (NLR) ratio predict symptomatic vasospasm or delayed cerebral ischemia (DCI) after aneurysmal subarachnoid haemorrhage (SAH)? T. Groza, N. Moreau, D. Castanares-Zapatero, P. Hantson P339 - ICU-acquired infections in aneurysmal subarachnoid hemorrhage patients: impact on ICU and hospital length of stay M. Carbonara , F. Ortolano, T. Zoerle, S. Magnoni, S. Pifferi, V. Conte, N. Stocchetti P340 - Cerebral metabolic effects of normobaric hyperoxia during the acute phase of aneurysmal subarachnoid hemorrhage L. Carteron, T. Suys, C. Patet, H. Quintard, M. Oddo P341 - Postoperative care for elective craniotomy: where is best done? J. A. Rubio, J. Rubio, R. Sierra P342 - 5-year follow-up of patients after transplantation of organs from donors from neurocritical care V. Spatenkova, E. Pokorna, P. Suchomel P343 - Evaluation of levetiracetam pharmacokinetics after severe traumatic brain injury in neurocritical care patients at a level one trauma center N. Ebert, J. Jancik, H. Rhodes P344 - Model based time series cluster analysis to determine unique patient states in traumatic brain injury T. Bylinski, C. Hawthorne, M. Shaw, I. Piper, J. Kinsella P345 - Brain compartment monitoring capabilities from ICP to BI (bioimpedance) during HS (hypertonic saline) administration. State of art simulation outcome depending on brain swelling type A. K. Kink , I. R. Rätsep P346 - Transfusion of red blood cells in patients with traumatic brain injury admitted to Canadian trauma health centers: a multicenter cohort study A. Boutin, L. Moore, M. Chasse, R. Zarychanski, F. Lauzier, S. English, L. McIntyre, J. Lacroix, D. Griesdale, P. Lessard-Bonaventure, A. F. Turgeon P347 - Hemoglobin thresholds and red blood cell transfusions in adult patients with moderate or severe traumatic brain injury: a retrospective cohort study A. Boutin, L. Moore, R. Green, P. Lessard-Bonaventure, M. Erdogan, M. Butler, F. Lauzier, M. Chasse, S. English, L. McIntyre, R. Zarychanski, J. Lacroix, D. Griesdale, P. Desjardins, D. A. Fergusson, A. F. Turgeon P348 - Characteristics of patients with gunshot wounds to the head - an observational Brazilian study B. Goncalves, B. Vidal, C. Valdez, A. C. Rodrigues, L. Miguez, G. Moralez P349 - Base excess as predictor for ICU admission and the injury severity in blunt trauma patients T. Hong P350 - Enhancement of usual emergency department care with proadrenomedullin to improve outcome prediction - Results from the multi-national, prospective, observational TRIAGE study A. Kutz, P. Hausfater, D. Amin, T. Struja, S. Haubitz, A. Huber, B. Mueller, P. Schuetz P351 - Developing an innovative emergency medicine point-of-care simulation programme T. Brown, J. Collinson, C. Pritchett, T. Slade P352 - The InSim program: an in situ simulation program for junior trainees in intensive care M. Le Guen, S. Hellings, R. Ramsaran P353 - Impact of excessive and inappropriate troponin testing in the emergency setting how good are we A. Alsheikhly P354 - The development of time tracking monitor at emergency department T. Abe P355 - Role of focussed echocardiography in emergency assessment of syncope L. Kanapeckaite, M. Abu-Habsa, R. Bahl P356 - Insertion of an open-ended 14-gauge catheter through the chest wall causes a significant pneumothorax in a self-ventilating swine model M. Q Russell, K. J. Real, M. Abu-Habsa , R. M. Lyon, N. P. Oveland P357 - Ez-io® intraosseous access teaching in the workplace using a mobile ‘tea trolley’ training method J. Penketh, M. Mcdonald, F. 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Leclerc P364 - A comparison of mortality scores in burns patients on the intensive care unit. O. Howarth, K. Davenport, P. Jeanrenaud, S. Raftery P365 - Clasification of pain and its treatment and an intensive care rehabiliation clinic P. MacTavish, H. Devine, J. McPeake, M. Daniel, J. Kinsella, T. Quasim P366 - Pain management adequacy in critical care areas ,the process and the barriers perceived by critical care nurses S. Alrabiee, A. Alrashid , S. Alsolamy P367 - Pain assessment in critically ill adult patients: validation of the Turkish version of the critical-care pain observation tool O. Gundogan, C. Bor, E. Akýn Korhan, K. Demirag , M. Uyar P368 - An audit of pain and sedation assessments in the intensive care unit: recommendations for clinical practice F. Frame, C. Ashton, L. Bergstrom Niska P369 - Impact of pharmaceutical care on treatment of pain and agitation in medical intensive care unit P. Dilokpattanamongkol, T. Suansanae, C. Suthisisang, S. Morakul, C. Karnjanarachata, V. Tangsujaritvijit P370 - Agitation in trauma ICU, prevention and outcome S. Mahmood, H. Al Thani, A. Almenyar P371 Correlation between percentages of ventilated patients developed vap and use of sedative agents in icu patients. A. Vakalos , V. Avramidis P372 - Improving recording of sedation events in the Emergency Department: The implementation of the SIVA International Taskforce adverse event reporting tool for procedural sedation R. Sharvill, J. Penketh P373 - Impact of sedative drug use on the length of mechanical ventilation S. E. Morton, Y. S. Chiew, C. Pretty, J. G. Chase, G. M. Shaw P374 - Co-administration of nitric oxide and sevoflurane using anaconda R. Knafelj, P. Kordis P375 - A retrospective study of the use of Dexmedetomidine in an oncological critical care setting S. Patel, V. Grover P376 - Dexmedetomidine and posttraumatic stress disorder incidence in alcohol withdrawal icu patients I. Kuchyn, K. Bielka P377 - Hemodynamic effects of dexmedetomidine in a porcine model of septic shock Z. Aidoni, V. Grosomanidis, K. Kotzampassi, G. Stavrou, B. Fyntanidou, S. Patsatzakis, C. Skourtis P378 - Ketamine for analgosedation in severe hypoxic respiratory failure S. D. Lee, K. Williams, I. D. Weltes P379 - Madness from the moon? lunar cycle and the incidence of delirium on the intensive care unit S. Berhane, C. Arrowsmith, C. Peters, S. Robert P380 - Impaired dynamic cerebral autoregulation after coronary artery bypass grafting and association with postoperative delirium J. Caldas, R. B. Panerai, T. G. Robinson, L. Camara, G. Ferreira, E. Borg-Seng-Shu, M. De Lima Oliveira, N. C. Mian, L. Santos, R. Nogueira, S. P. Zeferino, M. Jacobsen Teixeira, F. Galas, L. A. Hajjar P381 - Risk factors predicting prolonged intensive care unit length of stay after major elective surgery. P. Killeen, M. McPhail, W. Bernal, J. Maggs, J. Wendon, T. Hughes P382 - Systemic inflammatory response syndrome criteria and hospital mortality prediction in a brazilian cohort of critically ill patients L. U. Taniguchi, E. M. Siqueira, J. M. Vieira Jr, L. C. Azevedo P383 - Evaluating the efficacy of a risk predictor panel in identifying patients at elevated risk of morbidity following emergency admission A. N. Ahmad, M. Abu-Habsa, R. Bahl, E. Helme, S. Hadfield, R. Loveridge P384 - A retrospective comparison of outcomes for elective surgical patients admitted post-operatively to the critical care unit or general ward J. Shak, C. Senver, R. Howard-Griffin P385 - Effect of obesity on mortality in surgical critically ill patients. P. Wacharasint, P. Fuengfoo, N. Sukcharoen, R. Rangsin P386 - The national early warning score (news) reliably improves adverse clinical outcome prediction in community-acquired pneumonia - results from a 6 year follow-up D. Sbiti-Rohr, P. Schuetz P387 - Clinical usefulness of the charlson¡¯s weighted index of comorbidities _as prognostic factor in patients with prolonged acute mechanical ventilation H. Na, S. Song, S. Lee, E. Jeong, K. Lee P388 - Comparison of mortality prediction scoring systems in patients with cirrhosis admitted to general intensive care unit M. Cooper, K. Milinis, G. Williams, E. McCarron, S. Simants, I. Patanwala, I. D. Welters P389 - Impact of admission source and time of admission on outcome of pediatric intensive care patients: retrospective 15 years study E. Zoumpelouli, EA Volakli, V. Chrysohoidou, S. Georgiou, K. Charisopoulou, E. Kotzapanagiotou, V. Panagiotidou, K. Manavidou, Z. Stathi, M. Sdougka P390 - Heart rate variability and outcomes prediction in critical illness N. Salahuddin, B. AlGhamdi, Q. Marashly, K. Zaza, M. Sharshir, M. Khurshid, Z. Ali, M. Malgapo, M. Jamil, A. Shafquat, M. Shoukri, M. 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Vander Perre, T. Dufour, S. E. Thiessen, F. Güiza, T. Janssens, G. Hermans, I. Vanhorebeek, K. De Bock, G. Van den Berghe, L. Langouche P416 - Physical outcome measures for critical care patients following intensive care unit (icu) discharge H. Devine, P. MacTavish, T. Quasim, J. Kinsella, M. Daniel, J. McPeake P417 - Improving active mobilisation in a general intensive care unit B. Miles , S. Madden, H. Devine P418 - Mobilization in patients on vasoactive drugs use – a pilot study. M. Weiler, P. Marques, C. Rodrigues, M. Boeira, K. Brenner, C. Leães, A. Machado, R. Townsend, J. Andrade P419 - Pharmacy intervention at an intensive care rehabilitation clinic P. MacTavish, J. McPeake, H. Devine, J. Kinsella, M. Daniel, R. Kishore, C. Fenlon, T. Quasim P420 - Interactive gaming is feasible and potentially increases icu patients’ motivation to be engaged in rehabilitation programs T. Fiks, A. Ruijter, M. Te Raa, P. Spronk P421 - Simulation-based design of a robust stopping rule to ensure patient safety Y. S. Chiew, P. Docherty, J. Dickson, E. Moltchanova, C. Scarrot, C. Pretty, G. M. Shaw, J. G. Chase P422 - Are daily blood tests on the intensive care unit necessary? T. Hall, W. C. Ngu, J. M. Jack, P. Morgan P423 - Measuring urine output in ward patients: is it helpful? B. Avard, A. Pavli, X. Gee P424 - The incidence of pressure ulcers in an adult mixed intensive care unit in turkey C . Bor, E. Akin Korhan, K. Demirag, M. Uyar P425 - Intensivist/patient ratios in closed ICUs in Alexandria, Egypt; an overview M. Shirazy, A. Fayed P426 - Eicu (electronic intensive care unit): impact on ALOS (average length of stay) in a developing country like India S. Gupta, A. Kaushal, S. Dewan, A. Varma P427 - Predicting deterioration in general ward using early deterioration indicator E. Ghosh, L. Yang, L. Eshelman, B. Lord, E. Carlson P428 - High impact enhanced critical care outreach - the imobile service: making a difference E. Helme, R. Broderick, S. Hadfield, R. Loveridge P429 - Impact of bed availability and cognitive load on intensive care unit (ICU) bed allocation: a vignette-based trial J. Ramos, D. Forte P430 - Characteristics of critically ill patients admitted through the emergency department F. Yang, P. Hou P431 - Admission to critical care: the quantification of functional reserve J. Dudziak, J. Feeney, K. Wilkinson, K. Bauchmuller, K. Shuker, M. Faulds, A. Raithatha, D. Bryden, L. England, N. Bolton, A. Tridente P432 - Admission to critical care: the importance of frailty K. Bauchmuller, K Shuker, A Tridente, M Faulds, A Matheson, J. Gaynor, D Bryden, S South Yorkshire Hospitals Research Collaboration P433 - Development of an instrument to aid triage decisions for intensive care unit admission J. Ramos, B. Peroni, R. Daglius-Dias, L. Miranda, C. Cohen, C. Carvalho, I . Velasco, D. Forte P434 - Using selective serotonin re-uptake inhibitors and serotonin-norepinephrine re-uptake inhibitors in critical care: a systematic review of the evidence for benefit or harm J. M. Kelly, A. Neill, G. Rubenfeld, N. Masson, A. Min P435 - Measuring adaptive coping of hospitalized patients with a severe medical condition:the sickness insight in coping questionnaire (sicq) E. Boezeman, J. Hofhuis , A. Hovingh, R. De Vries, P. Spronk P436 - Results of a national survey regarding intensive care medicine training G. Cabral-Campello, I. Aragão, T. Cardoso P437 - Work engagement among healthcare professionals in the intensive care unit M. Van Mol, M. Nijkamp, E . Kompanje P438 - Empowering the intensive care practitioners. is it a burnout ameliorating intervention? P. Ostrowski, A. Omar P439 - Icu patients suffer from circadian rhythm desynchronisation K. Kiss , B. Köves, V. Csernus, Z. Molnár P440 - Noise reduction in the ICU: feasible ? Y. Hoydonckx, S. Vanwing, B. Stessel, A. Van Assche, L. Jamaer, J. Dubois P441 - Accidental removal of invasive devices in the critical patient into the bed-washing. does the presence of professional nurse modify his incidence? V. Medo, R. Galvez, J. P. Miranda P442 - Deprivation of liberty safeguards (dols): audit of compliance in a of a 16-bed specialist cancer critical care unit. C. Stone, T. Wigmore P443 - Use of a modified cristal score to predict futility of critical care in the elderly Y. Arunan, A. Wheeler, K. Bauchmuller, D. Bryden P444 - Improvement of Referral Rate to Palliative Care for Patients with Poor Prognosis in Neurosurgical Intensive Care Unit Y. Wong, C. Poi, C. Gu P445 - Factors associated with limitation of life supporting care (lsc) in a medico-surgical intermediate care unit, and outcome of patients with lsc limitation: a monocentric, six-month study. P. Molmy, N. Van Grunderbeeck, O. Nigeon, M. Lemyze, D. Thevenin, J. Mallat P446 - Palliative care consultation and intensive care unit admission request: a cohort study J. Ramos, M. Correa, R. T. Carvalho, D. Forte P447 - Nursing and medicine together in postsurgical intensive care unit: situations of prognostic conflict at the end of life. our critical care nurses suffer with our medical activism? A. Fernandez, C. McBride P448 - End of life who may decide E. Koonthalloor, C. Walsh P449 - Correctly diagnosing death A. Webber, M. Ashe, K. Smith, P. Jeanrenaud P450 - Skin procurement performed by intensive care physicians: yes, we can. A. Marudi , S. Baroni, F. Ragusa, E. Bertellini P451 - Death analysis in pediatric intensive care patients E. A. Volakli , E. Chochliourou, M. Dimitriadou, A. Violaki, P. Mantzafleri, E. Samkinidou, O. Vrani, A. Arbouti, T. Varsami, M. Sdougka P452 - The potential impact of euthanasia on organ donation: analysis of data from belgium J. A. Bollen, T. C. Van Smaalen, W. C. De Jongh, M. M. Ten Hoopen, D. Ysebaert, L. W. Van Heurn, W. N. Van Mook P453 - Communication within an intensive care setting K. Sim, A. Fuller P454 - Development and implementation of a longitudinal communication curriculum for critical care medicine fellows A. Roze des Ordons, P. Couillard, C. Doig P455 - Staff-family conflict in a multi-ethnic intensive care unit R. V. Van Keer, R. D. Deschepper, A. F. Francke, L. H. Huyghens, J. B. Bilsen P456 - Does the source of admission to critical care affect family satisfaction? B. Nyamaizi, C. Dalrymple, A. Molokhia, A. Dobru P457 - A simple alternative to the family satisfaction survey (fs-icu) E. Marrinan, A. Ankuli, A. Molokhia P458 - A study to explore the experiences of patient and family volunteers in a critical care environment: a phenomenological analysis J. McPeake, R. Struthers, R. Crawford , H. Devine , P. Mactavish , T. Quasim P459 - Prevalence and risk factors of anxiety and depression in relatives of burn patients. P. Morelli, M. Degiovanangelo, F. Lemos, V. MArtinez, F. Verga, J. Cabrera, G. Burghi P460 - Guidance of visiting children at an adult intensive care unit (icu) A. Rutten , S. Van Ieperen, S. De Geer, M. Van Vugt, E. Der Kinderen P461 - Visiting policies in Italian pediatric ICUs: an update A. Giannini, G Miccinesi, T Marchesi, E Prandi
- Published
- 2016
16. POSTER VIEWING SESSION - ENDOMETRIOSIS, ENDOMETRIUM, IMPLANTATION AND FALLOPIAN TUBE
- Author
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Palial, K. K., primary, Drury, J., additional, Heathcote, L., additional, Valentijin, A., additional, Farquharson, R. G., additional, Gazvani, R., additional, Rudland, P. S., additional, Hapangama, D. K., additional, Celik, N., additional, Celik, O., additional, Aktan, E., additional, Ozerol, E., additional, Celik, E., additional, Bozkurt, K., additional, Paran, H., additional, Hascalik, S., additional, Ozerol, I., additional, Arase, T., additional, Maruyama, T., additional, Uchida, H., additional, Miyazaki, K., additional, Oda, H., additional, Uchida-Nishikawa, S., additional, Kagami, M., additional, Yamazaki, A., additional, Tamaki, K., additional, Yoshimura, Y., additional, De Vos, M., additional, Ortega, C., additional, Smitz, J., additional, Van Vaerenbergh, I., additional, Bourgain, C., additional, Devroey, P., additional, Luciano, D., additional, Exacoustos, C., additional, Zupi, E., additional, Luciano, A. A., additional, Arduini, D., additional, Palomino, W. A., additional, Argandona, F., additional, Kohen, P., additional, Azua, R., additional, Scarella, A., additional, Devoto, L., additional, McKinnon, B., additional, Bersinger, N. A., additional, Mueller, M. D., additional, Bonavita, M., additional, Mattila, M., additional, Ferreira, F. P., additional, Maia-Filho, V., additional, Rocha, A. M., additional, Serafini, P., additional, Motta, E. L. A., additional, Kim, H., additional, Kim, C. H., additional, You, R. M., additional, Nah, H. Y., additional, Lee, J. W., additional, Kang, H. J., additional, Kang, B. M., additional, Letur - Koenirsch, H., additional, Haouzi, D., additional, Olivennes, F., additional, Rouleau, C., additional, Cohen-Bacri, P., additional, Dechaud, H., additional, Hamamah, S., additional, D'Hooghe, T., additional, Hummelshoj, L., additional, Dunselman, G. A. J., additional, Dirksen, C. D., additional, EndoCost Consortium, W. E. R. F., additional, Simoens, S., additional, Novembri, R., additional, Luisi, S., additional, Carrarelli, P., additional, Rocha, A. L. L., additional, Toti, P., additional, Reis, F. M., additional, Florio, P., additional, Petraglia, F., additional, Bruce, K. D., additional, Sadek, K. H., additional, Macklon, N., additional, Cagampang, F. R., additional, Cheong, Y., additional, Goudakou, M., additional, Kalogeraki, A., additional, Matalliotakis, I., additional, Papatheodorou, A., additional, Pasadaki, T., additional, Karkanaki, A., additional, Prapas, I., additional, Panagiotidis, I., additional, Kasapi, E., additional, Barlow, D., additional, Oliver, J., additional, Loumaye, E., additional, Khanmohammadi, M., additional, kazemnejad, S., additional, darzi, S., additional, Khanjani, S., additional, Zarnani, A., additional, Akhondi, M., additional, Tan, C. W., additional, Ng, C. P., additional, Loh, S. F., additional, Tan, H. H., additional, Choolani, M., additional, Griffith, L., additional, Chan, J., additional, Andersson, K. L., additional, Sundqvist, J., additional, Scarselli, G., additional, Gemzell-Danielsson, K., additional, Lalitkumar, P. G., additional, Jana, S., additional, Chattopadhyay, R., additional, Datta Ray, C., additional, Chaudhury, K., additional, Chakravarty, B. N., additional, Hannan, N., additional, Evans, J., additional, Hincks, C., additional, Rombauts, L. J. F., additional, Salamonsen, L. A., additional, Choi, D., additional, Lee, J., additional, Park, J., additional, Chang, H., additional, Kim, M., additional, Hwang, K., additional, Takeuchi, K., additional, Kurematsu, T., additional, Fukumoto, Y., additional, Yuki, Y., additional, Kuroki, Y., additional, Homan, Y., additional, Sata, Y., additional, Takeuchi, M., additional, Munoz Munoz, E., additional, Ortiz Olivera, G., additional, Fernandez Lopez, I., additional, Martinez Martinez, B., additional, Aguilar Prieto, J., additional, Portela Perez, S., additional, Pellicer Martinez, A., additional, Keltz, M., additional, Sauerbrun, M., additional, Breborowicz, A., additional, Gonzales, E., additional, Vicente-Munoz, S., additional, Puchades-Carrasco, L., additional, Morcillo, I., additional, Hidalgo, J. J., additional, Gilabert-Estelles, J., additional, Novella-Maestre, E., additional, Pellicer, A., additional, Pineda-Lucena, A., additional, Yavorovskaya, K. A., additional, Okhtyrskaya, T. A., additional, Demura, T. A., additional, Faizulina, N. M., additional, Ezhova, L. S., additional, Kogan, E. A., additional, Bilibio, J. P., additional, Souza, C. A. B., additional, Rodini, G. P., additional, Genro, V., additional, Andreoli, C. G., additional, de Conto, E., additional, Cunha-Filho, J. S. L., additional, Saare, M., additional, Soritsa, D., additional, Jarva, L., additional, Vaidla, K., additional, Palta, P., additional, Laan, M., additional, Karro, H., additional, Soritsa, A., additional, Salumets, A., additional, Peters, M., additional, Miskova, A., additional, Pilmane, M., additional, Rezeberga, D., additional, Assou, S., additional, Letur, H., additional, Piomboni, P., additional, Stendardi, A., additional, Gambera, L., additional, De Leo, V., additional, Focarelli, R., additional, Tamm, K., additional, Simm, J., additional, Metsis, M., additional, Vodolazkaia, A., additional, Fassbender, A., additional, Kyama, C. M., additional, Bokor, A., additional, Schols, D., additional, Huskens, D., additional, Meuleman, C., additional, Peeraer, K., additional, Tomassetti, C., additional, D'Hooghe, T. M., additional, Machens, K., additional, Afhuppe, W., additional, Schulz, A., additional, Diefenbach, K., additional, Schutt, B., additional, Faustmann, T., additional, Reischl, J., additional, Altmae, S., additional, Reimand, J., additional, Laisk, T., additional, Hovatta, O., additional, Kolde, R., additional, Vilo, J., additional, Stavreus-Evers, A., additional, Lee, J. H., additional, Kim, S. G., additional, Kim, Y. Y., additional, Park, I. H., additional, Sun, H. G., additional, Lee, K. H., additional, Ezoe, K., additional, Kawano, H., additional, Yabuuchi, A., additional, Ochiai, K., additional, Nagashima, H., additional, Osada, H., additional, Kagawa, N., additional, Kato, O., additional, Tamura, I., additional, Asada, H., additional, Taketani, T., additional, Tamura, H., additional, Sugino, N., additional, Garcia Velasco, J., additional, Prieto, L., additional, Quesada, J. F., additional, Cambero, O., additional, Toribio, M., additional, Hur, C. Y., additional, Lim, K. S., additional, Lee, W. D., additional, Lim, J. H., additional, Germeyer, A., additional, Nelson, L., additional, Graham, A., additional, Jauckus, J., additional, Strowitzki, T., additional, Lessey, B., additional, Gyulmamedova, I., additional, Illina, O., additional, Illin, I., additional, Mogilevkina, I., additional, Chaika, A., additional, Nosenko, O., additional, Boykova, I., additional, Gulmamedova, E., additional, Isik, H., additional, Moraloglu, O., additional, Seven, A. L. I., additional, Kilic, S., additional, Erkayiran, U., additional, Caydere, M., additional, Batioglu, S., additional, Alhalabi, M., additional, Samawi, S., additional, Taha, A., additional, Kafri, N., additional, Modi, S., additional, Khatib, A., additional, Sharif, J., additional, Othman, A., additional, Lancuba, S., additional, Branzini, C., additional, Lopez, M., additional, Baricalla, A., additional, Cristina, C., additional, Chen, J., additional, Jiang, Y., additional, Zhen, X., additional, Hu, Y., additional, Yan, G., additional, Sun, H., additional, Mizumoto, J., additional, Ueno, J., additional, Carvalho, F. M., additional, Casals, G., additional, Ordi, J., additional, Guimera, M., additional, Creus, M., additional, Fabregues, F., additional, Casamitjana, R., additional, Carmona, F., additional, Balasch, J., additional, Choi, Y. S., additional, Kim, K. C., additional, Kim, K. H., additional, Lee, B. S., additional, Kim, S. H., additional, Overbergh, L., additional, Verdrengh, E., additional, Kyama, C., additional, Waelkens, E., additional, Mathieu, C., additional, Iwasa, T., additional, Hatano, K., additional, Hasegawa, E., additional, Ito, H., additional, Isaka, K., additional, L. Rocha, A. L., additional, Reis, F., additional, Lee, K. S., additional, Joo, J. K., additional, Son, J. B., additional, Choi, J. R., additional, Vidali, A., additional, Barad, D. H., additional, Gleicher, N., additional, Sayyah-Melli, M., additional, and Kazemi-Shishvan, M., additional
- Published
- 2011
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17. Session 05: Endometriosis: Impact, Diagnosis and Surgery
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Nnoaham, K. E., primary, Sivananthan, S., additional, Hummelshoj, L., additional, Jenkinson, C., additional, Webster, P., additional, Kennedy, S. H., additional, Zondervan, K. T., additional, Vodolazkaia, A., additional, Fassbender, A., additional, Kyama, C. M., additional, Bokor, A., additional, Clerinx, P., additional, Gevaert, O., additional, Schols, D., additional, Huskens, D., additional, Meuleman, C., additional, Peeraer, K., additional, Tomassetti, C., additional, De Moor, B., additional, D'Hooghe, T. M., additional, Opoien, H. K., additional, Fedorcsak, P., additional, Abyholm, T., additional, Tanbo, T. G., additional, Kavallaris, A., additional, Hornemann, A., additional, Bohlmann, M., additional, Griesinger, G., additional, Chalvatzas, N., additional, Diedrich, K., additional, Benaglia, L., additional, Pasin, R., additional, Somigliana, E., additional, Vercellini, P., additional, Ragni, G., additional, Fedele, L., additional, Bergqvist, A., additional, Lundholm, C., additional, Malki, N., additional, Swahn, M. L., additional, Sparen, P., additional, and Melin, A., additional
- Published
- 2010
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18. Activated CD4+CD25+ regulatory T cells inhibit osteoclastogenesis and collagen-induced arthritis
- Author
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Kelchtermans, H, primary, Geboes, L, additional, Mitera, T, additional, Huskens, D, additional, Leclercq, G, additional, and Matthys, P, additional
- Published
- 2008
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19. The orally bioavailable allosteric CXCR4 HIV-1 entry inhibitor AMD11070
- Author
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Fricker Simon, Mosi Renee, Anastassova Virginia, Labrecque Jean, Wong Rebecca, Skerlj Renato, Bridger Gary, Huskens Dana, and Schols Dominique
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Immunologic diseases. Allergy ,RC581-607 - Published
- 2012
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20. Macrocyclic polyamines inhibit HIV infection by interacting with the cellular HIV co-receptors CXCR4 and CCR5
- Author
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Aquaro Stefano, Huskens Dana, Cui Li, Hamal Sunil, Schols Dominique, and Bell Thomas
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Immunologic diseases. Allergy ,RC581-607 - Published
- 2009
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21. Modest human immunodeficiency virus coreceptor function of CXCR3 is strongly enhanced by mimicking the CXCR4 ligand binding pocket in the CXCR3 receptor.
- Author
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Hatse, S., Huskens, D., and Princen, K.
- Published
- 2007
22. Comprehensive functional characterization of a novel ANO6 variant in a new patient with Scott syndrome.
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Montague SJ, Price J, Pennycott K, Pavey NJ, Martin EM, Thirlwell I, Kemble S, Monteiro C, Redmond-Motteram L, Lawson N, Reynolds K, Fratter C, Bignell P, Groenheide A, Huskens D, de Laat B, Pike JA, Poulter NS, Thomas SG, Lowe GC, Lancashire J, Harrison P, and Morgan NV
- Subjects
- Adult, Female, Humans, Male, Blood Coagulation genetics, Blood Platelets metabolism, Consanguinity, Genetic Predisposition to Disease, Homozygote, Pedigree, Phenotype, Phosphatidylserines, Phospholipid Transfer Proteins, Platelet Aggregation, Platelet Function Tests, Anoctamins genetics, Blood Coagulation Disorders genetics, Frameshift Mutation, Hemorrhage genetics, Hemorrhage blood, Thrombin metabolism
- Abstract
Background: Scott syndrome is a mild platelet-type bleeding disorder, first described in 1979, with only 3 unrelated families identified through defective phosphatidylserine (PS) exposure and confirmed by sequencing. The syndrome is distinguished by impaired surface exposure of procoagulant PS on platelets after stimulation. To date, platelet function and thrombin generation in this condition have not been extensively characterized., Objectives: Genetic and functional studies were undertaken in a consanguineous family with a history of excessive bleeding of unknown cause., Methods: A targeted gene panel of known bleeding and platelet genes was used to identify possible genetic variants. Platelet phenotyping, flow adhesion, flow cytometry, whole blood and platelet-rich plasma thrombin generation, and specialized extracellular vesicle measurements were performed., Results: We detected a novel homozygous frameshift variant, c.1943del (p.Arg648Hisfs∗23), in ANO6 encoding Anoctamin 6, in a patient with a bleeding history but interestingly with normal ANO6 expression. Phenotyping of the patient's platelets confirmed the absence of PS expression and procoagulant activity but also revealed other defects including reduced platelet δ granules, reduced ristocetin-mediated aggregation and secretion, and reduced P-selectin expression after stimulation. PS was absent on spread platelets, and thrombi formed over collagen at 1500/s. Reduced thrombin generation was observed in platelet-rich plasma and confirmed in whole blood using a new thrombin generation assay., Conclusion: We present a comprehensive report of a patient with Scott syndrome with a novel frameshift variant in AN06, which is associated with no platelet PS exposure and markedly reduced thrombin generation in whole blood, explaining the significant bleeding phenotype observed., Competing Interests: Declaration of competing interests A.G., D.H., and B.d.L. are employees of Synapse Research Institute, part of Diagnostica Stago S.A.S. All remaining authors declare no conflicts of interest., (Copyright © 2024 International Society on Thrombosis and Haemostasis. All rights reserved.)
- Published
- 2024
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23. Endogenous thrombin potential and time-dependent thrombin generation parameters are independent risk factors for mortality in the general population.
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de Laat-Kremers R, Costanzo S, Roest M, De Curtis A, Huskens D, Di Castelnuovo A, Ninivaggi M, Cerletti C, Donati MB, de Laat B, and Iacoviello L
- Subjects
- Humans, Male, Female, Middle Aged, Risk Factors, Prospective Studies, Time Factors, Aged, Adult, Proportional Hazards Models, Blood Coagulation Tests, Blood Coagulation, Risk Assessment, Cause of Death, Israel epidemiology, Thrombin metabolism
- Abstract
Background: Thrombin generation (TG) is used as a global test of coagulation and is an indicator of thrombosis and bleeding risk. Until now, data on the association of TG and mortality are inconclusive., Objectives: We investigated the association between TG and mortality in the prospective Moli-sani cohort (n = 21 920)., Methods: TG was measured using calibrated automated thrombinography using PPP-Reagent Low. Lag time (LT), endogenous thrombin potential (ETP), peak height, time-to-peak (TTP), and velocity index were quantified. The association of TG and mortality was studied by Cox regression and adjusted for sex, age, body mass index, smoking, contraceptives, and medical history (cardiovascular diseases, hypertension, hypercholesterolemia, diabetes, and cancer)., Results: LT and TTP were 4.1 ± 1.0 minutes and 6.6 ± 1.5 minutes, on average. The peak height was 364 ± 88 nM, velocity index was 163 ± 63 nM/min, and ETP was 1721 ± 411 nM·min. ETP was negatively associated with all-cause mortality (hazard ratio [HR], 0.86; 95% CI, 0.81-0.92; P < .001). Subjects in the lowest quintile of the ETP (ETP
Q1 ) had a 1.3-fold higher mortality rate. Additionally, a high TTP/LT ratio was negatively associated with mortality (HR, 0.71; 95% CI, 0.57-0.89; P = .003). Individuals in quintile 1 of the TTP/LT ratio had a 1.4-fold higher mortality rate compared with the remainder of the cohort. Subjects that were both in ETPQ1 and TTP/LTQ1 had a 1.8-fold higher mortality rate, regardless of whether they reported history of cardiovascular disease at baseline (HR, 1.61 [CI: 1.07-2.42]) or not (HR, 1.89 [CI: 1.51-2.36])., Conclusion: Low ETP and TTP/LT ratios are independent risk factors for all-cause mortality in the general population., Competing Interests: Declaration of competing interests R.d.L.K., M.R., D.H., M.N., and B.d.L. are employees of Synapse Research Institute, part of Diagnostica Stago SAS. S.C., A. De Curtis, A. Di Castelnuovo, C.C., M.B.D., and L.I. have no conflict of interest to disclose., (Copyright © 2024 International Society on Thrombosis and Haemostasis. Published by Elsevier Inc. All rights reserved.)- Published
- 2024
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24. Altered whole blood thrombin generation and hyperresponsive platelets in patients with pancreatic cancer.
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Willems RAL, Konings J, Huskens D, Middelveld H, Pepels-Aarts N, Verbeet L, de Groot PG, Heemskerk JWM, Ten Cate H, de Vos-Geelen J, de Laat B, and Roest M
- Subjects
- Humans, Thrombin, Blood Platelets, Venous Thromboembolism diagnosis, Venous Thromboembolism complications, Thrombosis etiology, Pancreatic Neoplasms complications, Carcinoma, Pancreatic Ductal
- Abstract
Background: Thromboembolic disease is a major complication in patients with pancreatic ductal adenocarcinoma (PDAC). Patients with PDAC often have altered blood cell counts, which are associated with venous thromboembolism (VTE) development. The high thrombotic risk in patients with PDAC may be partially caused by procoagulant blood cells., Objectives: The aim of this study was to compare blood cell-dependent coagulation between patients with PDAC (n = 18) and healthy controls matched for age and sex (n = 18)., Methods: Thrombin generation (TG) was measured in whole blood (WB) and plasma. The capacity of platelets to release granules (PGRCs) was measured in WB. We explored the occurrence of thromboembolic events in patients with PDAC during a 6-month follow-up., Results: Patients showed an increased endogenous thrombin potential in WB compared with controls. This difference was not observed in plasma, indicating a procoagulant effect of blood cells. Both in WB and plasma, the lag time was prolonged in patients compared with controls. Patients had hyperresponsive platelets, with a shorter time to peak granule release. Of the 18 patients with PDAC, 4 developed a venous thromboembolism (22%) and 1 developed an arterial thrombosis (6%). A shorter lag time in WB, but not in plasma, and an increased PGRC were associated with thromboembolic events., Conclusion: Patients with PDAC have an increased and delayed WB TG coagulation profile compared with controls. A shorter lag time in WB TG and increased PGRC are associated with the incidence of thromboembolic events. Platelets appear to be key players in thrombosis development. Measuring hemostasis in WB could improve thrombosis risk estimation in patients with PDAC., Competing Interests: Declaration of competing interests J.d.V.-G. has served as a consultant for Amgen, AstraZeneca, MSD, Pierre Fabre, and Servier and has received institutional research funding from Servier, all outside the submitted work. The other authors declare no conflicts of interest., (Copyright © 2024 International Society on Thrombosis and Haemostasis. Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
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25. Low factor XIII levels and altered fibrinolysis in patients with multiple myeloma.
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Ghansah H, Orbán-Kálmándi R, Debreceni IB, Katona É, Rejtő L, Váróczy L, Lóczi L, de Laat B, Huskens D, Kappelmayer J, and Bagoly Z
- Subjects
- Humans, Fibrinolysis, Factor XIII, Fibrinolysin, Antifibrinolytic Agents, Multiple Myeloma, Factor XIII Deficiency, Thrombophilia
- Abstract
Background: Acquired factor FXIII (FXIII) deficiency can be immune- or non-immune mediated and may cause severe bleeding symptoms. The incidence of acquired FXIII deficiency and its etiology in patients with multiple myeloma (MM) are poorly understood., Objectives: To assess FXIII levels and the balance of fibrinolysis in newly diagnosed, untreated MM and monoclonal gammopathy of undetermined significance (MGUS) patients., Methods: FXIII activity, mixing studies, FXIII-A
2 B2 antigen, total FXIII-B antigen were measured in platelet-poor plasma from 17 untreated MM patients, 33 untreated MGUS patients, and 30 age and sex-matched healthy controls. Besides routine laboratory measurements, the balance of coagulation and fibrinolysis was evaluated using quantitative fibrin monomer (FM) test, thrombin-antithrombin assay, α2-antiplasmin activity, plasmin-α2-antiplasmin (PAP) complex, D-dimer, plasmin generation assay, clot lysis assay, and ClotPro-TPA test., Results: FXIII-A2 B2 levels were significantly lower in MM patients compared to controls [median (IQR):14.6 (11.2-19.4) vs. 21.8 (17.1-26.4) mg/L, p = 0.0015], whereas total FXIII-B did not differ between groups. Decrease in FXIII activity was parallel to the decrease in FXIII-A2 B2 . An immune-mediated inhibitory mechanism was ruled out. Free/total FXIII-B was significantly higher in MM patients compared to MGUS and healthy controls, suggesting an etiology of FXIII-A consumption. In MM and MGUS patients, FM, D-dimer, and PAP complex were significantly elevated compared to controls, indicating hypercoagulability and ongoing fibrinolysis., Conclusions: Low FXIII levels due to consumption were observed in MM patients at diagnosis. Hypercoagulability and ongoing fibrinolysis were detected in MM and MGUS, indicating that a disturbed hemostasis balance is already present in the latter benign condition., Competing Interests: Declaration of competing interest The authors declare no competing interests., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)- Published
- 2024
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26. Crucial roles of red blood cells and platelets in whole blood thrombin generation.
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Sun S, Campello E, Zou J, Konings J, Huskens D, Wan J, Fernández DI, Reutelingsperger CPM, Ten Cate H, Toffanin S, Bulato C, de Groot PG, de Laat B, Simioni P, Heemskerk JWM, and Roest M
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- Humans, Thrombin metabolism, Phosphatidylserines, Annexin A5, Erythrocytes metabolism, Thrombosis, Coagulants, Anemia
- Abstract
Red blood cells (RBCs) and platelets contribute to the coagulation capacity in bleeding and thrombotic disorders. The thrombin generation (TG) process is considered to reflect the interactions between plasma coagulation and the various blood cells. Using a new high-throughput method capturing the complete TG curve, we were able to compare TG in whole blood and autologous platelet-rich and platelet-poor plasma to redefine the blood cell contributions to the clotting process. We report a faster and initially higher generation of thrombin and shorter coagulation time in whole blood than in platelet-rich plasma upon low concentrations of coagulant triggers, including tissue factor, Russell viper venom factor X, factor Xa, factor XIa, and thrombin. The TG was accelerated with increased hematocrit and delayed after prior treatment of RBC with phosphatidylserine-blocking annexin A5. RBC treatment with ionomycin increased phosphatidylserine exposure, confirmed by flow cytometry, and increased the TG process. In reconstituted blood samples, the prior selective blockage of phosphatidylserine on RBC with annexin A5 enhanced glycoprotein VI-induced platelet procoagulant activity. For patients with anemia or erythrocytosis, cluster analysis revealed high or low whole-blood TG profiles in specific cases of anemia. The TG profiles lowered upon annexin A5 addition in the presence of RBCs and thus were determined by the extent of phosphatidylserine exposure of blood cells. Profiles for patients with polycythemia vera undergoing treatment were similar to that of control subjects. We concluded that RBC and platelets, in a phosphatidylserine-dependent way, contribute to the TG process. Determination of the whole-blood hypo- or hyper-coagulant activity may help to characterize a bleeding or thrombosis risk., (© 2023 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)
- Published
- 2023
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27. Hyperresponsive Platelets and a Reduced Platelet Granule Release Capacity Are Associated with Severity and Mortality in COVID-19 Patients.
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Garishah FM, Huskens D, Pramudo SG, Andriani D, Astrilia M, Sentosa RA, van der Ven AJAM, Laat B, Gasem MH, de Mast Q, and Roest M
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- Humans, SARS-CoV-2, Blood Platelets metabolism, Critical Illness, C-Reactive Protein metabolism, Adenosine Triphosphate metabolism, Retrospective Studies, COVID-19, Thrombocytopenia
- Abstract
Background: Coronavirus disease 2019 (COVID-19) is often associated with mild thrombocytopenia and increased platelet reactivity., Objective: The aim of the current study was to investigate the adenosine triphosphate (ATP) release kinetics of platelets in hospitalized SARS-CoV-2-infected patients., Methods: We studied time-dependent platelet activation in whole blood by monitoring the ATP release kinetics upon stimulation with a PAR1 receptor agonist in 41 hospitalized critically ill COVID-19 patients, 47 hospitalized noncritically ill COVID-19 patients, and 30 healthy controls., Results: Our study demonstrated that platelets of critically ill COVID-19 patients were hyper-responsive with a shorter platelet response time (PRT) and a reduced platelet granule release capacity (GRC), probably due to chronic activation. The median PRT of COVID-19 patients admitted to the critical care unit was 10 and 7 seconds shorter than the median PRT in healthy controls and noncritical COVID-19 patients, respectively. Both PRT and GRC were also associated with D-dimer (Spearman r [ r
s ] = -0.51, p < 0.0001 and rs = -0.23, p < 0.05), C-reactive protein (CRP) ( rs = -0.59, p < 0.0001 and rs = -0.41, p < 0.01), and neutrophil-to-lymphocyte ratio (NLR) ( rs 0.01). These relationships remained significant after adjustment for age, sex, D-dimer, CRP, and NLR.p < 0.0001 and rs = -0.26, p < 0.05). Moreover, an increased PRT and a reduced GRC were associated with an increased mortality (odds ratio [OR]: 18.8, 95% confidence interval [CI]: 6.5-62.8, p < 0.0001 and OR: 4.0; 95% CI: 1.6-10.4, p < 0.01). These relationships remained significant after adjustment for age, sex, D-dimer, CRP, and NLR., Conclusion: Using an accessible agonist-induced platelet granule ATP release assay, we show that platelet hyper-responsiveness and reduced platelet GRC in COVID-19 patients were associated with critical illness and mortality., Competing Interests: None declared., (Thieme. All rights reserved.)- Published
- 2022
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28. Platelet Activation via Glycoprotein VI Initiates Thrombin Generation: A Potential Role for Platelet-Derived Factor IX?
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Li L, Roest M, Meijers JCM, de Laat B, Urbanus RT, de Groot PG, and Huskens D
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- Blood Coagulation Factors, Blood Platelets, Collagen, Glycoproteins, Humans, Platelet Activation, Platelet Membrane Glycoproteins, Factor IX, Thrombin
- Abstract
Collagen triggers coagulation via activation of factor (F) XII. In a platelet-rich environment, collagen can also trigger coagulation independently of FXII. We studied a novel mechanism of coagulation initiation via collagen-dependent platelet activation using thrombin generation (TG) in platelet-rich plasma. Collagen-induced coagulation is minimally affected by active-site inactivated FVIIa, anti-FVII antibodies, or FXIIa inhibition (corn trypsin inhibitor). Activation of platelets via specific glycoprotein (GP) VI agonists initiates TG, FX activation, and fibrin formation. To determine the platelet-derived trigger of coagulation, we systematically reconstituted factor-deficient plasmas with washed platelets. TG triggered by GPVI-activated platelets was significantly affected in FIX- and FVIII-deficient plasma but not in FVII- and FXII-deficient plasma. In a purified system composed of FX and FVIII, we observed that absence of FIX was compensated by GPVI-activated platelets, which could be inhibited by an anti-FIX antibody, suggesting FIXa activity from activated platelets. Furthermore, with the addition of FVIII in FIX-deficient plasma, TG induced by GPVI-activated platelets was restored, and was inhibited by the anti-FIX antibody. In conclusion, GPVI-activated platelets initiate TG, probably via platelet-derived FIXa activity., Competing Interests: M.R, B.d.L., P.G.d.G., and D.H. are employees of the research company Synapse BV (member of the Diagnostica Stago group)., (Thieme. All rights reserved.)
- Published
- 2022
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29. Population-wide persistent hemostatic changes after vaccination with ChAdOx1-S.
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de Laat B, Stragier H, de Laat-Kremers R, Ninivaggi M, Mesotten D, Thiessen S, Van Pelt K, Roest M, Penders J, Vanelderen P, Huskens D, De Jongh R, Laenen MV, Fivez T, Ten Cate H, Heylen R, Heylen L, and Steensels D
- Abstract
Various vaccines were developed to reduce the spread of the Severe Acute Respiratory Syndrome Cov-2 (SARS-CoV-2) virus. Quickly after the start of vaccination, reports emerged that anti-SARS-CoV-2 vaccines, including ChAdOx1-S, could be associated with an increased risk of thrombosis. We investigated the hemostatic changes after ChAdOx1-S vaccination in 631 health care workers. Blood samples were collected 32 days on average after the second ChAdOx1-S vaccination, to evaluate hemostatic markers such as D-dimer, fibrinogen, α2-macroglobulin, FVIII and thrombin generation. Endothelial function was assessed by measuring Von Willebrand Factor (VWF) and active VWF. IL-6 and IL-10 were measured to study the activation of the immune system. Additionally, SARS-CoV-2 anti-nucleoside and anti-spike protein antibody titers were determined. Prothrombin and fibrinogen levels were significantly reduced after vaccination (-7.5% and -16.9%, p < 0.0001). Significantly more vaccinated subjects were outside the normal range compared to controls for prothrombin (42.1% vs. 26.4%, p = 0.026) and antithrombin (23.9% vs. 3.6%, p = 0.0010). Thrombin generation indicated a more procoagulant profile, characterized by a significantly shortened lag time (-11.3%, p < 0.0001) and time-to-peak (-13.0% and p < 0.0001) and an increased peak height (32.6%, p = 0.0015) in vaccinated subjects compared to unvaccinated controls. Increased VWF (+39.5%, p < 0.0001) and active VWF levels (+24.1 %, p < 0.0001) pointed toward endothelial activation, and IL-10 levels were significantly increased (9.29 pg/mL vs. 2.43 pg/mL, p = 0.032). The persistent increase of IL-10 indicates that the immune system remains active after ChAdOx1-S vaccination. This could trigger a pathophysiological mechanism causing an increased thrombin generation profile and vascular endothelial activation, which could subsequently result in and increased risk of thrombotic events., Competing Interests: BL, RdL-K, MR, DH, and MN are employees of Synapse Research Institute, part of Diagnostica Stago. HC received funding for research from Bayer and Pfizer; compensation fees for consultancy and advisory boards from Daaichi, Pfizer, Leo, Bayer, Galapagos, Anthos, Alexion, and Alveron; shareholder from Coagulation profile; all benefits were transferred to the CARIM institute to support investigator-initiated research. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 de Laat, Stragier, de Laat-Kremers, Ninivaggi, Mesotten, Thiessen, Van Pelt, Roest, Penders, Vanelderen, Huskens, De Jongh, Laenen, Fivez, ten Cate, Heylen, Heylen and Steensels.)
- Published
- 2022
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30. Patients With Multiple Myeloma Have a Disbalanced Whole Blood Thrombin Generation Profile.
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Li L, Roest M, Sang Y, Remijn JA, Fijnheer R, Smit K, Huskens D, Wan J, de Laat B, and Konings J
- Abstract
Background: Multiple myeloma (MM) is associated with a high prevalence of bleeding and an increased risk of thrombo-embolism. MM patients have reduced platelet- and red blood cell (RBC) numbers in blood, which may indicate that the paradoxical hemostasis profile is a consequence of a disturbed platelet and RBC homeostasis., Objectives: To get better insight in the disbalanced hemostasis of MM patients., Methods: We conducted a case-control study on the whole blood (WB) coagulation profiles of 21 MM patients and 21 controls. We measured thrombin generation (TG) in WB and platelet poor plasma (PPP) of MM patients and controls., Results: In WB-TG, we observed that the median time to the thrombin Peak was 52% longer in MM patients than in controls, while the median endogenous thrombin potential until the Peak (ETPp) was 39% higher in MM-patients than in controls. In line with these findings, the levels of platelets, RBCs, white blood cells and agonist induced platelet activation were decreased in MM patients compared to controls. The plasma TG experiments showed no differences between MM-patients and controls., Conclusion: Patients with MM have a disturbed blood cell metabolism and a disbalanced WB-TG profile. This disbalance may explain the paradoxically high prevalence of bleeding symptoms in MM patients vs. an increased thrombosis risk. There was no disturbance observed in plasma TG, indicating that blood cells are the major determinants for the disbalanced hemostasis in MM patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Li, Roest, Sang, Remijn, Fijnheer, Smit, Huskens, Wan, de Laat and Konings.)
- Published
- 2022
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31. Increased BMI and Blood Lipids Are Associated With a Hypercoagulable State in the Moli-sani Cohort.
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de Laat-Kremers R, Di Castelnuovo A, van der Vorm L, Costanzo S, Ninivaggi M, Cerletti C, Huskens D, De Curtis A, Gialluisi A, Bai C, de Gaetano G, Yin D, Donati MB, de Laat B, and Iacoviello L
- Abstract
The coagulation system can be assessed by the thrombin generation (TG) assay, and increased TG peak height, endogenous thrombin potential (ETP), and velocity index are associated with an increased risk of thrombosis. Obesity had been reported to increase TG and is associated with dyslipidemia, which also predisposes to atherosclerotic cardiovascular disease (CVD). However, the effect of the blood lipid profile on TG has not been studied extensively. To gain more insight into the associations of TG, body mass index (BMI) and lipid profile, we studied TG in relation to these parameters in a large Italian population cohort, the Moli-sani study ( N = 22,546; age ≥ 35 years; 48% men). TG was measured in plasma samples collected at the enrollment of subjects in the Moli-sani study. TG was triggered with 1 or 5 pM tissue factor, and TG parameters lag time, peak, ETP, time-to-peak (TTP) and velocity index (VI). Additionally, thrombomodulin was added to assess the function of the activated protein C system during TG. In both women and men, overweight (BMI 25-30 kg/m
2 ) and obesity (BMI > 30 kg/m2 ) were significantly associated with higher ETP, peak and VI (all p < 0.001). High total cholesterol, triglycerides and LDL-cholesterol levels were significantly associated with increased ETP and peak (all p < 0.001). Linear regression analysis revealed that the ETP is positively associated with both plasma LDL and HDL cholesterol levels, whereas the velocity index is positively associated with HDL cholesterol. Additionally, ETP, peak and VI were significantly associated with the plasma triglycerides content. In conclusion, our study shows significant associations of high BMI and blood lipid levels with increased TG parameters, and this hypercoagulability may partly explain the increased risk of CVD in individuals with obesity and/or dyslipidemia., Competing Interests: Synapse Research Institute is a non-for-profit organization, member of Diagnostica Stago SAS. RdLK, LvdV, MN, DH, CB, DY, and BdL are employees of Synapse Research Institute. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 de Laat-Kremers, Di Castelnuovo, van der Vorm, Costanzo, Ninivaggi, Cerletti, Huskens, De Curtis, Gialluisi, Bai, de Gaetano, Yin, Donati, de Laat, Iacoviello and the Moli-sani Investigators.)- Published
- 2022
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32. Flow cytometric analysis of platelet function to detect high on-treatment residual platelet reactivity in patients on dual antiplatelet therapy.
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Li L, Huskens D, Florin L, de Laat B, Roest M, and Devreese KMJ
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- Blood Platelets, Humans, Platelet Aggregation, Platelet Aggregation Inhibitors pharmacology, Platelet Aggregation Inhibitors therapeutic use, Platelet Function Tests
- Published
- 2022
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33. Differences in thrombin and plasmin generation potential between East African and Western European adults: The role of genetic and non-genetic factors.
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Temba GS, Vadaq N, Wan J, Kullaya V, Huskens D, Pecht T, Jaeger M, Boahen CK, Matzaraki V, Broeders W, Joosten LAB, Faradz SMH, Kibiki G, Middeldorp S, Cavalieri D, Lionetti P, de Groot PG, Schultze JL, Netea MG, Kumar V, de Laat B, Mmbaga BT, van der Ven AJ, Roest M, and de Mast Q
- Subjects
- Adult, Black People, Blood Coagulation genetics, Blood Coagulation Tests, Humans, Inflammation genetics, Netherlands, Tanzania, White People, Fibrinolysin metabolism, Thrombin metabolism
- Abstract
Background: Geographic variability in coagulation across populations and their determinants are poorly understood., Objective: To compare thrombin (TG) and plasmin (PG) generation parameters between healthy Tanzanian and Dutch individuals, and to study associations with inflammation and different genetic, host and environmental factors., Methods: TG and PG parameters were measured in 313 Tanzanians of African descent living in Tanzania and 392 Dutch of European descent living in the Netherlands and related to results of a dietary questionnaire, circulating inflammatory markers, genotyping, and plasma metabolomics., Results: Tanzanians exhibited an enhanced TG and PG capacity, compared to Dutch participants. A higher proportion of Tanzanians had a TG value in the upper quartile with a PG value in the lower/middle quartile, suggesting a relative pro-coagulant state. Tanzanians also displayed an increased normalized thrombomodulin sensitivity ratio, suggesting reduced sensitivity to protein C. In Tanzanians, PG parameters (lag time and TTP) were associated with seasonality and food-derived plasma metabolites. The Tanzanians had higher concentrations of pro-inflammatory cytokines, which correlated strongly with TG and PG parameters. There was limited overlap in genetic variation associated with TG and PG parameters between the two cohorts. Pathway analysis of genetic variants in the Tanzanian cohort revealed multiple immune pathways that were enriched with TG and PG traits, confirming the importance of co-regulation between coagulation and inflammation., Conclusions: Tanzanians have an enhanced TG and PG potential compared to Dutch individuals, which may relate to differences in inflammation, genetics and diet. These observations highlight the importance of better understanding of the geographic variability in coagulation across populations., (© 2022 The Authors. Journal of Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis.)
- Published
- 2022
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34. Osteoprotegerin modulates platelet adhesion to von Willebrand factor during release from endothelial cells.
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Wohner N, Sebastian S, Muczynski V, Huskens D, de Laat B, de Groot PG, and Lenting PJ
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- Animals, Blood Platelets metabolism, Endothelial Cells metabolism, Humans, Mice, Osteoprotegerin metabolism, Platelet Adhesiveness, Ristocetin, von Willebrand Diseases genetics, von Willebrand Factor metabolism
- Abstract
Background: Platelet-binding Von Willebrand Factor (VWF) strings assemble upon stimulated secretion from endothelial cells., Objectives: To investigate the efficiency of platelet binding to multi-molecular VWF bundles secreted from endothelial cells and to investigate the role of osteoprotegerin, a protein located in Weibel-Palade bodies that interacts with the VWF platelet binding domain., Methods: The nanobody VWF/AU-a11 that specifically binds to VWF in its active platelet-binding conformation was used to investigate the conformation of VWF., Results: Upon stimulated secretion from endothelial cells, VWF strings were only partially covered with platelets, while a VWD-type 2B mutation or ristocetin enhanced platelet binding by 2-3-fold. Osteoprotegrin, reduces platelet adhesion to VWF by 40% ± 18% in perfusion assays. siRNA-mediated down-regulation of endothelial osteoprotegerin expression resulted in a 1.8-fold increase in platelet adhesion to VWF strings. Upon viral infection, there is a concordant rise in VWF and osteoprotegerin plasma levels. Unexpectedly, no such increase was observed in plasma of desmopressin-treated hemophilia A-patients. In a mouse model, osteoprotegerin expression was low in liver endothelial cells of vehicle-treated mice, and concanavalin A-treatment increased VWF and osteoprotegerin expression 4- and 40-fold, respectively. This increase was translated in a 30-fold increased osteoprotegerin/VWF ratio in plasma., Conclusions: Release of VWF from endothelial cells opens the platelet-binding site, irrespective of the presence of flow. However, not all available platelet-binding sites are being occupied, suggesting some extent of regulation. Part of this regulation involves endothelial proteins that are co-secreted with VWF, like osteoprotegerin. This regulatory mechanism may be of more relevance under inflammatory conditions., (© 2021 International Society on Thrombosis and Haemostasis.)
- Published
- 2022
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35. Aprotinin Inhibits Thrombin Generation by Inhibition of the Intrinsic Pathway, but is not a Direct Thrombin Inhibitor.
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Lisman T, Adelmeijer J, Huskens D, and Meijers JCM
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Background Aprotinin is a broad-acting serine protease inhibitor that has been clinically used to prevent blood loss during major surgical procedures including cardiac surgery and liver transplantation. The prohemostatic properties of aprotinin likely are related to its antifibrinolytic effects, but other mechanisms including preservation of platelet function have been proposed. Aim Here we assessed effects of aprotinin on various hemostatic pathways in vitro, and compared effects to tranexamic acid(TXA), which is an antifibrinolytic but not a serine protease inhibitor. Methods We used plasma-based clot lysis assays, clotting assays in whole blood, plasma, and using purified proteins, and platelet activation assays to which aprotinin or TXA were added in pharmacological concentrations. Results Aprotinin and TXA dose-dependently inhibited fibrinolysis in plasma. Aprotinin inhibited clot formation and thrombin generation initiated via the intrinsic pathway, but had no effect on reactions initiated by tissue factor. However, in the presence of thrombomodulin, aprotinin enhanced thrombin generation in reactions started by tissue factor. TXA had no effect on coagulation. Aprotinin did not inhibit thrombin, only weakly inhibited the TF-VIIa complex and had no effect on platelet activation and aggregation by various agonists including thrombin. Aprotinin and TXA inhibited plasmin-induced platelet activation. Conclusion Pharmacologically relevant concentrations of aprotinin inhibit coagulation initiated via the intrinsic pathway. The antifibrinolytic activity of aprotinin likely explains the prohemostatic effects of aprotinin during surgical procedures. The anticoagulant properties may be beneficial during surgical procedures in which pathological activation of the intrinsic pathway, for example by extracorporeal circuits, occurs., Competing Interests: Conflicts of Interest This study was sponsored in part by an unrestricted educational grant of Nordic Pharma to TL. The other authors have no conflicts of interest to report., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. ( https://creativecommons.org/licenses/by/4.0/ ).)
- Published
- 2021
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36. Vascular activation is a strong predictor of mortality in coronavirus disease 2019 patients on the ICU.
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De Jongh R, Ninivaggi M, Mesotten D, Bai C, Marcus B, Huskens D, Stragier H, Miszta A, Verbruggen J, de Laat-Kremers RMW, Grieten J, and de Laat B
- Subjects
- ADAMTS13 Protein deficiency, Aged, Aged, 80 and over, Biomarkers, Blood Proteins analysis, COVID-19 complications, COVID-19 mortality, Cross-Sectional Studies, Endothelium, Vascular metabolism, Extracorporeal Circulation, Female, Fibrinolysin biosynthesis, Fibrinolysis, Hemostasis, Heparin therapeutic use, Humans, Intensive Care Units, Male, Middle Aged, Partial Thromboplastin Time, Prognosis, Thrombin biosynthesis, ADAMTS13 Protein blood, COVID-19 blood, Endothelium, Vascular physiopathology, SARS-CoV-2 isolation & purification, von Willebrand Factor analysis
- Abstract
Respiratory failure in coronavirus disease 2019 (COVID-19) patients is one of the most frequent causes for referral to the ICU. A significant percentage of these patients does not survive the infection due to thromboembolic complications. Furthermore, the vascular system seems also to be involved in the pathogenesis. To investigate the role of hemostasis and endothelium on the outcome of COVID-19 patients admitted to the ICU. Blood was drawn from 16 ICU COVID-19 patients for hemostatic analysis. Patients were followed-up till discharge (n = 11) or death (n = 5). Parameters related to both coagulation and fibrinolysis, though disturbed, were not associated with mortality. Contrarily, activated Von Willebrand factor was increased and ADAMTS13 levels were decreased by two-fold in nonsurvivors compared with survivors. Our data established the involvement of the Von Willebrand factor-ADAMTS13 axis in the COVID-19 pathogenesis, thereby demonstrating that these plasma proteins seem to be strong predictors for ICU mortality., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
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37. Assessing Plasmin Generation in Health and Disease.
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Miszta A, Huskens D, Donkervoort D, Roberts MJM, Wolberg AS, and de Laat B
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- Animals, Antifibrinolytic Agents blood, Fibrin analysis, Fibrin chemistry, Fibrinolytic Agents blood, Humans, Plasminogen analysis, Plasminogen chemistry, Plasminogen metabolism, Blood Chemical Analysis methods, Disease, Fibrinolysin analysis, Fibrinolysin metabolism
- Abstract
Fibrinolysis is an important process in hemostasis responsible for dissolving the clot during wound healing. Plasmin is a central enzyme in this process via its capacity to cleave fibrin. The kinetics of plasmin generation (PG) and inhibition during fibrinolysis have been poorly understood until the recent development of assays to quantify these metrics. The assessment of plasmin kinetics allows for the identification of fibrinolytic dysfunction and better understanding of the relationships between abnormal fibrin dissolution and disease pathogenesis. Additionally, direct measurement of the inhibition of PG by antifibrinolytic medications, such as tranexamic acid, can be a useful tool to assess the risks and effectiveness of antifibrinolytic therapy in hemorrhagic diseases. This review provides an overview of available PG assays to directly measure the kinetics of plasmin formation and inhibition in human and mouse plasmas and focuses on their applications in defining the role of plasmin in diseases, including angioedema, hemophilia, rare bleeding disorders, COVID-19, or diet-induced obesity. Moreover, this review introduces the PG assay as a promising clinical and research method to monitor antifibrinolytic medications and screen for genetic or acquired fibrinolytic disorders.
- Published
- 2021
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38. Interplay between platelets and coagulation.
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Sang Y, Roest M, de Laat B, de Groot PG, and Huskens D
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- Blood Coagulation Disorders blood, Blood Coagulation Disorders diagnosis, Blood Coagulation Disorders etiology, Blood Coagulation Factors metabolism, Blood Coagulation Tests, Disease Susceptibility, Humans, Platelet Activation, Platelet Aggregation, Platelet Membrane Glycoproteins metabolism, Protein Binding, Blood Coagulation, Blood Platelets physiology, Hemostasis
- Abstract
Haemostasis stops bleeding at the site of vascular injury and maintains the integrity of blood vessels through clot formation. This regulated physiological process consists of complex interactions between endothelial cells, platelets, von Willebrand factor and coagulation factors. Haemostasis is initiated by a damaged vessel wall, followed with a rapid adhesion, activation and aggregation of platelets to the exposed subendothelial extracellular matrix. At the same time, coagulation factors aggregate on the procoagulant surface of activated platelets to consolidate the platelet plug by forming a mesh of cross-linked fibrin. Platelets and coagulation mutually influence each other and there are strong indications that, thanks to the interplay between platelets and coagulation, haemostasis is far more effective than the two processes separately. Clinically this is relevant because impaired interaction between platelets and coagulation may result in bleeding complications, while excessive platelet-coagulation interaction induces a high thrombotic risk. In this review, platelets, coagulation factors and the complex interaction between them will be discussed in detail., (Copyright © 2020 Elsevier Ltd. All rights reserved.)
- Published
- 2021
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39. Flow cytometric analysis of platelet function to improve the recognition of thrombocytopathy.
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Huskens D, Li L, Florin L, de Kesel P, de Laat B, Roest M, and Devreese KMJ
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- Blood Platelets, Flow Cytometry, Humans, Platelet Activation, Platelet Aggregation Inhibitors pharmacology, Platelet Function Tests, Blood Platelet Disorders diagnosis, Platelet Aggregation
- Abstract
Introduction: Light transmission aggregometry (LTA) is the gold standard for diagnosing bleeding disorders. Although LTA is laborious, requires large volumes of blood and is relatively insensitive to small changes in platelet function, there is still no competing alternative approach to replace LTA for the diagnosis of platelet bleeding disorders., Materials and Methods: This study investigates the correlation between flow cytometry-based whole blood platelet activation test (WB-PACT) and LTA and whether WB-PACT is of additional value for the identification of bleeding disorders. In total, 161 patients with suspected bleeding diathesis were tested., Results: A correlation of 0.41 between LTA and WB-PACT was found, and there was agreement between tests in 62% of cases (κ = 0.23). The WB-PACT is of additional value to LTA to detect platelet function disorders (PFD) as 10 patients with elevated bleeding score (BS) were detected with WB-PACT, 4 with LTA and 7 patients were positive with both tests. Interestingly, in contrast to LTA, WB-PACT has an additional option to detect VWF disfunctions., Conclusion: WB-PACT may have added value for the routine diagnostic work-up in patients who need to have platelet function tested., Competing Interests: Declaration of competing interest The authors report no declarations of interest. Some of the authors are employees of the research company Synapse BV (member of the Diagnostica Stago group)., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2020
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40. Acute exacerbations of COPD are associated with a prothrombotic state through platelet-monocyte complexes, endothelial activation and increased thrombin generation.
- Author
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van der Vorm LN, Li L, Huskens D, Hulstein JJJ, Roest M, de Groot PG, Ten Cate H, de Laat B, Remijn JA, and Simons SO
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- Aged, Cardiovascular Diseases etiology, Female, Fibrinolysis, Humans, Inflammation, Male, Middle Aged, Prospective Studies, Pulmonary Disease, Chronic Obstructive blood, Recurrence, Blood Coagulation, Blood Platelets physiology, Disease Progression, Endothelium physiology, Monocytes physiology, Platelet Activation, Pulmonary Disease, Chronic Obstructive etiology, Pulmonary Disease, Chronic Obstructive physiopathology, Thrombin metabolism
- Abstract
Introduction: Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for cardiovascular events, particularly following an acute exacerbation (AE-COPD). Exacerbations are associated with increased systemic inflammation, which may drive coagulation. This prospective cohort study aimed to determine how an AE-COPD affects platelet activation, the endothelium, plasmatic coagulation and fibrinolysis, and its association with systemic inflammation., Materials and Methods: Fifty-two patients with an AE-COPD were included. Blood samples at admission, at day 3 of treatment and at convalescence were available for 32 patients. Platelet-monocyte complex (PMC) formation, monocyte Mac-1 expression and platelet (re)activity (P-selectin expression, αIIbβ3 activation) were measured by flow cytometry. Von Willebrand Factor (VWF), thrombin generation (TG) and clot lysis time (CLT) were determined as measures of endothelial activation, plasmatic coagulation and fibrinolysis, respectively., Results: Exacerbations were associated with increased PMCs (MFI 31.3 vs 23.8, p = 0.004) and Mac-1 (MFI 38.2 vs 34.8, p = 0.006) compared to convalescence, but not with changes in platelet (re)activity. VWF (antigen, activity, active fraction) and TG (peak, ETP and velocity index) were all significantly higher during AE-COPD compared to convalescence. PMCs, Mac-1, VWF and TG were positively associated with systemic inflammation (CRP). CLT was prolonged in AE-COPD patients with systemic inflammation. Moreover, platelet hyperreactivity on admission was associated with an increased risk for exacerbation relapse., Conclusions: Acute exacerbations are associated with an inflammation-associated prothrombotic state, characterized by increased PMCs, endothelial activation and plasmatic coagulation. Our findings provide direction for future studies on biomarkers predicting the risk of exacerbation relapse and cardiovascular events., (Copyright © 2020 Elsevier Ltd. All rights reserved.)
- Published
- 2020
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41. A Synthetic Triple Helical Collagen Peptide as a New Agonist for Flow Cytometric Measurement of GPVI-Specific Platelet Activation.
- Author
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Sang Y, Huskens D, Wichapong K, de Laat B, Nicolaes GAF, and Roest M
- Subjects
- Adult, Aged, Binding Sites, Blood Platelets metabolism, Carrier Proteins pharmacology, Cysteine chemistry, Female, Flow Cytometry, Healthy Volunteers, Humans, Male, Middle Aged, P-Selectin metabolism, Peptides chemistry, Peptides pharmacology, Platelet Adhesiveness drug effects, Platelet Glycoprotein GPIIb-IIIa Complex metabolism, Protein Domains, Protein Engineering methods, Young Adult, Collagen chemistry, Collagen pharmacology, Platelet Activation drug effects, Platelet Membrane Glycoproteins agonists
- Abstract
Synthetic cross-linked collagen-related peptide (CRP-XL) is a glycoprotein VI (GPVI) receptor activator for platelet activation. This triple helical peptide, widely used in platelet function tests, is synthesized and cross-linked through cysteine residues at its N-terminus and C-terminus. Currently, there is only one laboratory, which is capable to produce this valuable peptide for clinical applications. In an attempt to provide a standardized alternative for CRP-XL, we developed a synthetic triple helical collagen peptide (STH-CP) with the same primary sequence as CRP-XL (GPC-(GPO)
10 -GPCG-amide)3 , which was both on the C-terminus and on the N-terminus fixed on a scaffold with a binding side for each of the three peptides. The performance of STH-CP on platelet function was studied using flow cytometry and compared with CRP-XL. We found that platelet activation pattern in response to STH-CP and CRP-XL is similar, although the STH-CP requires sixfold higher concentrations to activate platelets to the same state. The intra-assay percent coefficient of variation of STH-CP and CRP-XL were both < 5% and the interindividual variation measured in 118 individuals for both peptides was around 23 and 21% for αIIbβ3 activation and P-selectin expression, respectively. The STH-CP in ready-to-use reaction mix has lower variation than CRP-XL over 1-year storage. In reference values and seasonal variation study, the platelet activation response showed a strong correlation between STH-CP and CRP-XL.Our findings show that this new STH-CP is a stable and potent platelet GPVI agonist which can induce the same reproducible platelet activation as CRP-XL and that STH-CP can be considered as a good alternative for CRP-XL., Competing Interests: Y.S. reports grants from China Scholarship Council during the conduct of the study. D.H., B.d-L. and M.R. are employees of the research company Synapse BV (member of the Diagnostica Stago Group)., (Georg Thieme Verlag KG Stuttgart · New York.)- Published
- 2019
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42. A Hypoxic Environment Attenuates Exercise-Induced Procoagulant Changes Due to Decreased Platelet Activation.
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Kicken CH, van der Vorm LN, Zwaveling S, Schoenmaker E, Remijn JA, Huskens D, and de Laat B
- Abstract
Introduction Although physical exercise is protective against cardiovascular disease, it can also provoke sudden cardiac death (exercise paradox). Epidemiological studies suggest that systemic hypoxia at high altitude is a risk factor for venous thromboembolism. Forthcoming, this study investigated the effect of repeated exercise at high altitude on blood coagulation, platelet function, and fibrinolysis. Methods Six trained male volunteers were recruited. Participants ascended from sea level to 3,375 m altitude. They performed four exercise tests at 65 to 80% of their heart-rate reserve during 2 hours: one time at sea level and three times on consecutive days at 3,375 m altitude. Thrombin generation (TG) was measured in whole blood (WB) and platelet-rich and platelet-poor plasma. Coagulation factor levels were measured. Platelet activation was measured as αIIbβ3 activation and P-selectin expression. Fibrinolysis was studied using a clot-lysis assay. Results Normoxic exercise increased plasma peak TG through increased factor VIII (FVIII), and increased von Willebrand factor (VWF) and active VWF levels. Platelet granule release potential was slightly decreased. After repetitive hypoxic exercise, the increase in (active) VWF tapered, and there was no more distinct exercise-related increase in peak. Platelet aggregation potential and platelet-dependent TG decreased at high altitude. There were no effects on fibrinolysis upon exercise and/or hypoxia. Conclusion Strenuous exercise induces a procoagulant state that is mediated by the endothelium, by increasing VWF and secondarily raising FVIII levels. After repetitive exercise, the amplitude of the endothelial response to exercise diminishes. A hypoxic environment appears to further attenuate the procoagulant changes by decreasing platelet activation and platelet-dependent TG.
- Published
- 2019
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43. Circulating active von Willebrand factor levels are increased in chronic kidney disease and end-stage renal disease.
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van der Vorm LN, Visser R, Huskens D, Veninga A, Adams DL, Remijn JA, Hemker HC, Rensma PL, van Horssen R, and de Laat B
- Published
- 2019
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44. Analytical characterization and reference interval of an enzyme-linked immunosorbent assay for active von Willebrand factor.
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van der Vorm LN, Li L, Huskens D, Chayouâ W, Kelchtermans H, de Groot PG, Roest M, Remijn JA, and de Laat B
- Subjects
- Adolescent, Adult, Aged, Antibodies metabolism, Blood Platelets metabolism, Enzyme-Linked Immunosorbent Assay methods, Enzyme-Linked Immunosorbent Assay standards, Epitopes analysis, Epitopes metabolism, Female, Humans, Male, Middle Aged, Reference Values, Young Adult, von Willebrand Diseases diagnosis, von Willebrand Factor immunology, von Willebrand Factor metabolism, von Willebrand Diseases blood, von Willebrand Factor analysis
- Abstract
Background: Interaction of von Willebrand factor (VWF) with platelets requires a conformational change that exposes an epitope within the VWF A1 domain, enabling platelet glycoprotein Ibα binding. Quantification of this ''active" conformation of VWF has been shown to provide pathophysiological insight into conditions characterized by excessive VWF-platelet interaction., Methods: We developed an immunosorbent assay based on a variable heavy chain antibody fragment against the VWF A1 domain as a capture antibody. Assay performance in terms of specificity (binding to active R1306W- and sheared VWF), precision, accuracy, linearity, limits of detection and stability were determined. Active VWF, VWF antigen, VWF ristocetin cofactor activity, VWF:GP1bM and VWF propeptide were measured in citrated plasma and platelet-VWF binding in whole blood from 120 healthy individuals to establish a reference interval for active VWF and to assess associations with other VWF parameters., Results: Intra- and inter-assay CVs were between 2.4-7.2% and 4.1-9.4%, depending on the level. Mean recovery of spiked recombinant R1306W VWF was 103±3%. The assay was linear in the range of 90.1-424.5% and had a limit of quantification of 101%. The reference interval for active VWF was 91.6-154.8% of NPP. Significant, positive correlations between active VWF and all other VWF parameters were found, with the strongest correlation with VWF:GP1bM binding., Conclusions: We developed and validated an immunosorbent assay for the accurate detection of active VWF levels in plasma. The assay fulfilled all analytical criteria in this study and a reference interval was established, allowing its use to quantify active VWF in pathological conditions for future research., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2019
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45. Effects of Repeated Bouts of Exercise on the Hemostatic System.
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van der Vorm LN, Huskens D, Kicken CH, Remijn JA, Roest M, de Laat B, and Miszta A
- Subjects
- Factor VIII metabolism, Humans, Pilot Projects, von Willebrand Factor metabolism, Blood Platelets metabolism, Exercise physiology, Hemostasis physiology, Physical Exertion physiology
- Abstract
Physical activity is beneficial for health, for example, by lowering the risk of cardiovascular events. However, vigorous exercise is associated with the occurrence of thromboembolic events and sudden cardiac death, in particular in untrained individuals. Whereas acute exercise is known to cause a hypercoagulable state, repeated exposure to (strenuous) exercise by means of training may actually condition the hemostatic response to exercise. To date, the effects of exercise training on blood coagulability and the underlying mechanisms have yet to be fully discerned. In this review, the authors provide an overview of existing literature on how training programs and training status influence hemostasis in healthy individuals. Furthermore, they present data of a pilot study in which we studied the effects of repetitive submaximal intensity cycling on procoagulant and anticoagulant processes. It is known that factor VIII (FVIII) and von Willebrand factor (VWF) increase after exercise, but we found that this increase in FVIII and VWF (antigen, propeptide, and VWF in active conformation) was smaller on each of three subsequent days, suggesting either adaptation of endothelial activation or exhaustion of endothelial VWF supplies. With respect to thrombin generation, elevated FVIII significantly increased the thrombin generation peak but not the endogenous thrombin potential. In contrast, platelet activation in terms of P-selectin expression after stimulation with protease-activated receptor-1 and glycoprotein VI agonists decreased after exercise and did not recover, indicating exhaustion of the platelet response to repetitive exercise., Competing Interests: None., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)
- Published
- 2018
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46. Thrombin generation and platelet activation in cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy - A prospective cohort study.
- Author
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Van Poucke S, Huskens D, Van der Speeten K, Roest M, Lauwereins B, Zheng MH, Dehaene S, Penders J, Marcus A, and Lancé M
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Neoplasm Metastasis, Peritoneal Neoplasms pathology, Prospective Studies, Thrombelastography, Thrombin Time, Cytoreduction Surgical Procedures, Hyperthermia, Induced, Peritoneal Neoplasms blood, Peritoneal Neoplasms therapy, Platelet Activation, Thrombin metabolism
- Abstract
Background and Objectives: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal peroperative chemotherapy (HIPEC), indicated for patients with peritoneal metastases from digestive or gynecological malignancies alike, demonstrates a considerable impact on hemostatic metabolism, both on platelet and on coagulation level. The potential hemostatic interference in CRS and HIPEC is phase dependent. The hypothesis of this prospective cohort study is that the procedure exposed an increased thrombotic risk, resulting in a faster and increased thrombin generation and hyper platelet function., Methods: This study explores the combined use of ROTEM (rotational thromboelastometry), PACT (platelet activation test) and CAT (thrombin generation test) assays during CRS and HIPEC with a follow-up of 7 days postoperative in 27 patients with confirmed histological diagnosis of peritoneal disease., Results: Platelet reactivity (relative to before incision values) to CRP (collagen-related peptide) (p value 0.02) and TRAP (thrombin receptor activator peptide) (p value 0.048) seems to be slightly reduced during CRS and HIPEC with regard to αIIbβ3 activation, while P-selectin expression is not affected. During surgery, CAT demonstrates that, the LT (lagtime) (p value 0.0003) and TTP (time-to-thrombin peak) values (p value 0.002) decrease while and the TP (thrombin peak) (p value 0.004) and ETP (endogenous thrombin potential) (p value 0.02) increase. Subsequently, after surgery, the LT and TTP increase and ETP and TP decrease in time. ROTEM EXTEM (extrinsic) MCF (maximum clot firmness) (p value 0.005), INTEM (intrinsic) MCF (p value 0.003) and FIBTEM (fibrinogen) MCF (p value <0.001) decreased during CRS. At day 7 INTEM and FIBTEM MCF values (p values of 0.004 and <0.001) were significantly higher than before surgery. No considerable changes in platelet count and hemoglobin concentration and absence of leukopenia are noticed., Conclusion: This approach detects changes in coagulation much earlier than noticed by standard coagulation tests., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2018
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47. Effects of Plasmin on von Willebrand Factor and Platelets: A Narrative Review.
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van der Vorm LN, Remijn JA, de Laat B, and Huskens D
- Abstract
Plasmin is the major fibrinolytic protease responsible for dissolving thrombi by cleavage of its primary substrate fibrin. In addition, emerging evidence points to other roles of plasmin: (1) as a back-up for ADAMTS13 in proteolysis of ultra-large von Willebrand factor (VWF) multimers and (2) as an activator of platelets. Although the molecular mechanisms of fibrinolysis are well defined, insights on the effects of plasmin on VWF and platelets are relatively scarce and sometimes conflicting. Hence, this review provides an overview of the literature on the effects of plasmin on VWF multimeric structures, on VWF binding to platelets, and on platelet activation. This information is placed in the context of possible applications of thrombolytic therapy for the condition thrombotic thrombocytopenic purpura.
- Published
- 2018
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48. Hypobaric Hypoxia Causes Elevated Thrombin Generation Mediated by FVIII that is Balanced by Decreased Platelet Activation.
- Author
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Kicken CH, Ninivaggi M, Konings J, Moorlag M, Huskens D, Remijn JA, Bloemen S, Lancé MD, and De Laat B
- Subjects
- Acclimatization, Adult, Altitude Sickness blood, Altitude Sickness diagnosis, Altitude Sickness etiology, Blood Coagulation Tests, Female, Humans, Hypoxia diagnosis, Hypoxia etiology, Male, Middle Aged, Platelet Function Tests, Risk Factors, Time Factors, Venous Thromboembolism diagnosis, Venous Thromboembolism etiology, Young Adult, Altitude, Blood Platelets metabolism, Factor VIII metabolism, Hypoxia blood, Platelet Activation, Thrombin metabolism, Venous Thromboembolism blood
- Abstract
Introduction: Epidemiological studies suggest that hypobaric hypoxia at high altitude poses a risk for developing venous thromboembolism. The cause of this observed hypercoagulability remains unclear. Therefore, this study aimed to investigate the effect of hypobaric hypoxia at 3,883 m above sea level on thrombin generation and platelet activation., Methods: After complying with medical ethical procedures, 18 participants were recruited, of whom 1 had to leave the study prematurely due to mild acute mountain sickness. Blood was drawn first at 50 m above sea level and second at 3,883 m altitude after gradual acclimatization for 6 days. Thrombin generation was measured in whole blood, platelet-rich plasma and platelet-poor plasma. Platelet activation was assessed using a whole blood flow-cytometric assay. Coagulation factor levels, D-dimer levels and markers of dehydration and inflammation were measured., Results: Hypobaric hypoxia at 3,883 m altitude caused increased thrombin generation, measured as peak height and endogenous thrombin potential, in whole blood, platelet-rich and platelet-poor plasma without or at low tissue factor concentration. The elevated thrombin generation was mediated by increased factor VIII levels and not caused by dehydration or inflammation. In contrast, spontaneous and agonist-induced platelet activation was decreased at high altitude., Conclusion: Hypobaric hypoxia causes increased factor VIII-mediated thrombin generation. The hypercoagulability was balanced by decreased platelet activation. These findings may explain why venous, and not arterial thrombotic events occur more frequently at high altitude., Competing Interests: None., (Schattauer GmbH Stuttgart.)
- Published
- 2018
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49. Standardization and reference ranges for whole blood platelet function measurements using a flow cytometric platelet activation test.
- Author
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Huskens D, Sang Y, Konings J, van der Vorm L, de Laat B, Kelchtermans H, and Roest M
- Subjects
- Female, Flow Cytometry, Humans, Male, Platelet Activation, Reference Values, Platelet Function Tests methods
- Abstract
Introduction: Platelet function testing with flow cytometry has additional value to existing platelet function testing for diagnosing bleeding disorders, monitoring anti-platelet therapy, transfusion medicine and prediction of thrombosis. The major challenge is to use this technique as a diagnostic test. The aim of this study is to standardize preparation, optimization and validation of the test kit and to determine reference values in a population of 129 healthy individuals., Methods: Platelet function tests with 3 agonists and antibodies against P-selectin, activated αIIbβ3 and glycoprotein Ib (GPIb), were prepared and stored at -20°C until used. Diluted whole blood was added and platelet activation was quantified by the density of activation markers, using flow cytometry. Anti-mouse Ig κ particles were included to validate stability of the test and to standardize results. Reference intervals were determined., Results: Blood stored at room temperature (RT) for up to 4h after blood donation and preheated/tested at 37°C resulted in stable results (%CV<10%), in contrast to measuring at RT. The intra-assay %CV was <5%. Incubation of anti-mouse Ig κ particles with antibodies stored for up to 12 months proved to give a stable fluorescence. The inter-individual variation measured in the 129 individuals varied between 23% and 37% for P-selectin expression and αIIbβ3 activation, respectively., Conclusions: The current study contributes to the translation of flow cytometry based platelet function testing from a scientific tool to a diagnostic test. Platelet function measurements, using prepared and stored platelet activation kits, are reproducible if executed at 37°C. The reference ranges can be validated in clinical laboratories and ongoing studies are investigating if reduced platelet reactivity in patients with bleeding complications can be detected.
- Published
- 2018
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50. Interindividual Variability and Normal Ranges of Whole Blood and Plasma Thrombin Generation.
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Bloemen S, Huskens D, Konings J, Kremers RM, Miszta A, de Laat B, and Kelchtermans H
- Abstract
Background: Assays measuring thrombin generation (TG) in plasma increasingly gained attention in the field of thrombosis and hemostasis. Adaptation of the method enabled the measurement of TG in whole blood (WB). Despite their potential, TG assays did not reach the stage of universal clinical application, partly because of the absence of normal ranges. Our study aimed to accurately determine normal ranges and interindividual variability of TG and correlate results with coagulation factor levels, sex, and oral contraceptive usage., Methods: The study protocol was evaluated by the local medical ethical board. In total, 129 healthy volunteers gave full informed consent. Normal ranges of TG in platelet-poor plasma (PPP), platelet-rich plasma (PRP), and WB were determined according to CLSI guidelines., Results: Our study is the first to measure normal ranges of TG in PPP, PRP, and WB in a large healthy cohort. Significant correlations were found between TG in plasma and WB. Interindividual variability of TG in WB was comparable to that of plasma. Oral contraceptive use increased TG in PPP, PRP, and WB. The inhibitory effect of thrombomodulin on TG was significantly lower in females than in males. This effect was more pronounced upon oral contraceptive use. Primary clotting factor determinants for TG parameters depended on the tissue factor concentration, but were similar in WB and plasma., Conclusions: Establishing normal ranges for TG brings us 1 step closer to clinical use. Good correlations between plasma and WB (including clotting factor determinants for TG) suggest that WB TG can be reliably used in clinic., (© 2017 American Association for Clinical Chemistry.)
- Published
- 2017
- Full Text
- View/download PDF
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