Impaired platelet reactivity in patients with septic shock: a proof-of-concept study

Coagulation disorders and thrombocytopenia are common in patients with septic shock, but only few studies have focused on platelet variables beyond platelet count. The aim of this study was to evaluate whether platelets reactivity predicts sepsis-induced thrombocytopenia in patients with septic shoc...

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Published in:	Platelets (Edinburgh) Vol. 31; no. 5; pp. 652 - 660
Main Authors:	Fogagnolo, Alberto, Taccone, Fabio Silvio, Campo, Gianluca, Montanari, Giacomo, Capatti, Beatrice, Ferraro, Gioconda, Erriquez, Andrea, Ragazzi, Riccardo, Creteur, Jacques, Volta, Carlo Alberto, Spadaro, Savino
Format:	Journal Article
Language:	English
Published:	England Taylor & Francis 03-07-2020 Taylor & Francis Group
Subjects:	Aged Blood Coagulation Disorders - blood Blood Coagulation Disorders - complications Blood Platelets - metabolism Critical care disseminated intravascular coagulation Female Humans Male Middle Aged Pilot Projects Platelet Count - methods platelet reactivity Proof of Concept Study sepsis Septic shock Shock, Septic - blood thrombocytopenia Critical care Septic shock platelet reactivity thrombocytopenia disseminated intravascular coagulation sepsis
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Summary:	Coagulation disorders and thrombocytopenia are common in patients with septic shock, but only few studies have focused on platelet variables beyond platelet count. The aim of this study was to evaluate whether platelets reactivity predicts sepsis-induced thrombocytopenia in patients with septic shock. We therefore enrolled consecutive patients with septic shock and platelets count >15010 3 /μL on the day of the diagnosis. Platelets reactivity tests were performed daily from the diagnosis of septic shock until day five; platelet volume distribution and mean platelet volume were also recorded daily. Sepsis-induced thrombocytopenia was defined as a platelet count <15010 3 /μL. Thirty patients were included; sepsis-induced thrombocytopenia occurred in 11 (31%) patients. Platelets reactivity and platelet count at day of septic shock diagnosis were not correlated. Patients who experienced thrombocytopenia had lower maximal aggregation at diagnosis than others. Maximal aggregation tests were predictors of thrombocytopenia (AUROC from 0.756 to 0.797, depending on the agonist used). Both platelet volume distribution width and mean platelet volume were predictors of 90-day mortality (AUROC 0.866 and 0.735, respectively). In this pilot study, impaired platelets reactivity was more common in patients who subsequently developed sepsis-induced thrombocytopenia; also, platelet volume distribution width and mean platelet volume were predictors of 90-day mortality.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0953-7104 1369-1635
DOI:	10.1080/09537104.2019.1663807