Effects of platelet dysfunction and platelet transfusion on outcomes in traumatic brain injury patients
| Autor: | Andrew R Guillotte, Richard D. Hammer, Joseph P Herbert, Richard W. Madsen, N. Scott Litofsky |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Tomography Scanners X-Ray Computed Traumatic brain injury Platelet dysfunction Neuroscience (miscellaneous) Platelet Transfusion Platelet inhibition 03 medical and health sciences 0302 clinical medicine Brain Injuries Traumatic Developmental and Educational Psychology medicine Coagulopathy Humans Platelet Prospective Studies Aged Aged 80 and over Medication use Arachidonic Acid medicine.diagnostic_test business.industry Incidence 030208 emergency & critical care medicine Middle Aged medicine.disease Thromboelastography Thrombelastography Adenosine Diphosphate Treatment Outcome Platelet transfusion Anesthesia Female Blood Platelet Disorders Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Brain Injury. 32:1849-1857 |
| ISSN: | 1362-301X 0269-9052 |
| Popis: | Platelet inhibition in traumatic brain injury (TBI) may be due to injury or antiplatelet medication use pre-injury. This study aims to identify factors associated with increased platelet arachidonic acid (AA) and adenosine diphosphate (ADP) inhibition and determine if platelet transfusion reduces platelet dysfunction and affects outcome.Prospective thromboelastography (TEG) assays were collected on adult patients with TBI with intracranial injuries detected by computed tomography (CT). Outcomes included in-hospital mortality, and CT lesion expansion.Of 153 patients, ADP inhibition was increased in moderate and severe TBI compared to mild TBI (p = 0.0011). P2Y12 inhibiting medications had increased ADP inhibition (p = 0.0077). Admission ADP inhibition was not associated with in-hospital mortality (p = 0.24) or CT lesion expansion (p = 0.94). Mean reduction of ADP inhibition from platelet transfusion (-15.1%) relative to no transfusion (+ 11.7%) was not statistically different (p = 0.0472).Mild TBI results in less ADP inhibition compared to moderate and severe TBI, suggesting a dose response relationship between TBI severity and degree of platelet dysfunction. Further, study is warranted to determine efficacy and parameters for platelet transfusion in patients with TBI. |
| Databáze: | OpenAIRE |
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