Platelet function following trauma
- 1 January 2011
- journal article
- Published by Georg Thieme Verlag KG in Thrombosis and Haemostasis
- Vol. 106 (08), 322-330
- https://doi.org/10.1160/th11-03-0175
Abstract
Platelets play a central role in coagulation. Currently, information on platelet function following trauma is limited. We performed a retrospective analysis of patients admitted to the emergency room (ER) at the AUVA Trauma Centre, Salzburg, after sustaining traumatic injury. Immediately after admission to the ER, blood was drawn for blood cell counts, standard coagulation tests, and platelet function testing. Platelet function was assessed by multiplate electrode aggregometry (MEA) using adenosine diphosphate (ADPtest), collagen (COLtest) and thrombin receptor activating peptide-6 (TRAPtest) as activators. The thromboelastometric platelet component, measuring the contribution of platelets to the elasticity of the whole-blood clot, was assessed using the ROTEM® device. The study included 163 patients, 79.7% were male, and the median age was 43 years. The median injury severity score was 18. Twenty patients (12.3%) died. Median platelet count was significantly lower among non-survivors than survivors (181,000/μl vs. 212,000/μl; p=0.01). Although platelet function defects were relatively minor, significant differences between survivors and non-survivors were observed in the ADPtest (94 vs. 79 U; p=0.0019), TRAPtest (136 vs. 115 U; pEXTEM – MCEFIBTEM; p=0.0012). Aggregometry values below the normal range for ADPtest and TRAPtest were significantly more frequent in non-survivors than in survivors (p=0.0017 and p=0.0002, respectively). Minor decreases in platelet function upon admission to the ER were a sign of coagulopathy accompanying increased mortality in patients with trauma. Further studies are warranted to confirm these results and investigate the role of platelet function in trauma haemostatic management. Note: This work was carried out at the AUVA Trauma Centre, Salzburg, Austria.Keywords
This publication has 30 references indexed in Scilit:
- Mechanism of hemostasis defects and management of bleeding in patients with acute coronary syndromesEuropean Journal of Internal Medicine, 2010
- Dual low response to acetylsalicylic acid and clopidogrel is associated with myonecrosis and stent thrombosis after coronary stent implantationAmerican Heart Journal, 2010
- Platelet transfusions: the science behind safety, risks and appropriate applicationsBest Practice & Research Clinical Anaesthesiology, 2010
- Management of bleeding following major trauma: an updated European guidelineCritical Care, 2010
- Platelet concentrates transfusion in cardiac surgery and platelet function assessment by multiple electrode aggregometryActa Anaesthesiologica Scandinavica, 2009
- Effect of Haemostatic Control Resuscitation on mortality in massively bleeding patients: a before and after studyVox Sanguinis, 2009
- Evaluation of aspirin response by Multiplate® whole blood aggregometry and light transmission aggregometryPlatelets, 2009
- Mechanisms of Thrombus FormationNew England Journal of Medicine, 2008
- Damage Control ResuscitationJournal Of Trauma-Injury Infection and Critical Care, 2007
- Platelet Activation and Function after TraumaJournal Of Trauma-Injury Infection and Critical Care, 2001