The Role of Whole Blood Impedance Aggregometry and Its Utilisation in the Diagnosis and Prognosis of Patients with Systemic Inflammatory Response Syndrome and Sepsis in Acute Critical Illness
Davies, Gareth R.
Mills, Gavin M.
Williams, Phylip R.
Evans, Phillip A.
MetadataShow full item record
Objective: To assess the prognostic and diagnostic value of whole blood impedance aggregometry in patients with sepsis and SIRS and to compare with whole blood parameters (platelet count, haemoglobin, haematocrit and white cell count). Methods: We performed an observational, prospective study in the acute setting. Platelet function was determined using whole blood impedance aggregometry (multiplate) on admission to the Emergency Department or Intensive Care Unit and at 6 and 24 hours post admission. Platelet count, haemoglobin, haematocrit and white cell count were also determined. Results: 106 adult patients that met SIRS and sepsis criteria were included. Platelet aggregation was significantly reduced in patients with severe sepsis/septic shock when compared to SIRS/uncomplicated sepsis (ADP: 90.7±37.6 vs 61.4±40.6; p<0.001, Arachadonic Acid 99.9±48.3 vs 66.3±50.2; p = 0.001, Collagen 102.6±33.0 vs 79.1±38.8; p = 0.001; SD ± mean)). Furthermore platelet aggregation was significantly reduced in the 28 day mortality group when compared with the survival group (Arachadonic Acid 58.8±47.7 vs 91.1±50.9; p<0.05, Collagen 36.6±36.6 vs 98.0±35.1; p = 0.001; SD ± mean)). However haemoglobin, haematocrit and platelet count were more effective at distinguishing between subgroups and were equally effective indicators of prognosis. Significant positive correlations were observed between whole blood impedance aggregometry and platelet count (ADP 0.588 p<0.0001, Arachadonic Acid 0.611 p<0.0001, Collagen 0.599 p<0.0001 (Pearson correlation)). Conclusions: Reduced platelet aggregometry responses were not only significantly associated with morbidity and mortality in sepsis and SIRS patients, but also correlated with the different pathological groups. Whole blood aggregometry significantly correlated with platelet count, however, when we adjust for the different groups we investigated, the effect of platelet count appears to be non-significant.
Davies, G.R., Mills, G.M., Lawrence, M., Battle, C., Morris, K., Hawkins, K., Williams, P.R., Davidson, S., Thomas, D. and Evans, P.A. (2014) 'The role of whole blood impedance aggregometry and its utilisation in the diagnosis and prognosis of patients with systemic inflammatory response syndrome and sepsis in acute critical illness', PLoS One, 9(9), p.e108589. DOI: 10.1371/journal.pone.0108589.
Article published in PLoS ONE on 30 September 2014, available open access at: https://doi.org/10.1371/journal.pone.0108589.
Cardiff Metropolitan University (Grant ID: Cardiff Metropolian (Internal))
This work is part-funded by the European Social Fund (ESF) through the European Union's Convergence programme administered by the Welsh Government.
Showing items related by title, author, subject and abstract.
Assessment of platelet function in patients with stroke using multiple electrode platelet aggregometry: a prospective observational study Sabra, Ahmed; Stanford, Sophia N.; Lawrence, Matthew; D'Silva, Lindsay; Morris, Keith; Evans, Vanessa; Wani, Mushtaq; Potter, John F.; Evans, Phillip A. (BioMed Cental, 2016-12-09)Background There is a link between high on-treatment platelet reactivity (HPR) and adverse vascular events in stroke. This study aimed to compare multiple electrode platelet aggregometry (MEA), in healthy subjects and ...
Changes in platelet function independent of pharmacotherapy following coronary intervention in non-ST-elevation myocardial infarction patients Freeman, Phillips M.; Moschonas, Konstantinos E.; Hinz, Christine; O'Donnell, Valerie B.; Kinnaird, Tim D.; James, Philip; Anderson, Richard A. (Elsevier, 2015)Background High on treatment platelet reactivity (HTPR) is common in patients receiving clopidogrel following an acute coronary syndrome (ACS); it's also associated with increased morbidity and mortality. More potent and ...
The Inflammatory Effects of Blood Donation-Derived Extracellular Microvesicles on a Monocytic THP-1 Cell Line Assessed by the Production of IL-8 and IL-10 Harvey, Joshua (Cardiff Metropolitan University, 2017-06-01)Currently, contradictory evidence for Red Blood Cell (RBC) survival and mortality of patients post-transfusion of stored blood has led to an international disagreement over the clinical effects of transfusing stored blood. ...