Desmopressin, Misoprostol, nor Carboprost Affect Platelet Aggregability Following Traumatic Brain Injury and Aspirin.

Autor: Baucom MR; Department of Surgery, University of Cincinnati, Cincinnati, Ohio., Price AD; Department of Surgery, University of Cincinnati, Cincinnati, Ohio., Weissman N; Department of Surgery, University of Cincinnati, Cincinnati, Ohio., England L; Department of Surgery, University of Cincinnati, Cincinnati, Ohio., Schuster RM; Department of Surgery, University of Cincinnati, Cincinnati, Ohio., Pritts TA; Department of Surgery, University of Cincinnati, Cincinnati, Ohio., Goodman MD; Department of Surgery, University of Cincinnati, Cincinnati, Ohio. Electronic address: michael.goodman@ucmail.uc.edu.
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2024 Apr; Vol. 296, pp. 643-653. Date of Electronic Publication: 2024 Feb 14.
DOI: 10.1016/j.jss.2024.01.027
Abstrakt: Introduction: Desmopressin (DDAVP) has been utilized clinically in patients taking aspirin (ASA) to improve drug-induced platelet dysfunction. Misoprostol and carboprost, prostaglandin analogs commonly used for postpartum hemorrhage, may also induce platelet aggregation. The aim of this study was to determine the effects of DDAVP, misoprostol, and carboprost administration on platelet aggregability following traumatic brain injury (TBI) in mice treated with ASA.
Methods: Male C57BL/6 mice were randomized into seven groups (n = 5 each): untouched, ASA only, Saline/TBI, ASA/TBI, ASA/TBI/DDAVP 0.4 μg/kg, ASA/TBI/misoprostol 1 mg/kg, and ASA/TBI/carboprost 100 μg/kg. TBI was induced via a weight drop model 4-h after ASA (50 mg/kg) gavage. Mice were given an intraperitoneal injection of DDAVP, misoprostol, or carboprost 10 minutes after TBI. In vivo testing was completed utilizing tail vein bleed. Mice were sacrificed 30-min posttreatment and blood was collected via cardiac puncture. Whole blood was analyzed via Multiplate impedance aggregometry, rotational thromboelastometry, and TEG6s.
Results: Mice receiving misoprostol after ASA/TBI demonstrated decreased tail vein bleeding times compared to ASA only treated mice. However, mice treated with misoprostol following ASA and TBI demonstrated decreased platelet aggregability compared to untouched mice and TBI only mice within the arachidonic acid agonist pathway. By contrast, DDAVP and carboprost did not significantly change platelet aggregability via adenosine diphosphate or arachidonic acid following ASA and TBI. However, DDAVP did decrease the platelet contribution to clot via rotational thromboelastometry.
Conclusions: Reversal of medication-induced platelet inhibition has become increasingly controversial after TBI. Based on these results, DDAVP, misoprostol, nor carboprost consistently improve platelet aggregability following TBI in those also treated with ASA.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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