PMID- 22520693
OWN - NLM
STAT- MEDLINE
DCOM- 20120611
LR  - 20240315
IS  - 1879-1190 (Electronic)
IS  - 1072-7515 (Print)
IS  - 1072-7515 (Linking)
VI  - 214
IP  - 5
DP  - 2012 May
TI  - Early platelet dysfunction: an unrecognized role in the acute coagulopathy of 
      trauma.
PG  - 739-46
LID - 10.1016/j.jamcollsurg.2012.01.050 [doi]
AB  - BACKGROUND: Our aim was to determine the prevalence of platelet dysfunction using 
      an end point of assembly into a stable thrombus after severe injury. Although the 
      current debate on acute traumatic coagulopathy has focused on the consumption or 
      inhibition of coagulation factors, the question of early platelet dysfunction in 
      this setting remains unclear. STUDY DESIGN: Prospective platelet function in 
      assembly and stability of the thrombus was determined within 30 minutes of injury 
      using whole blood samples from trauma patients at the point of care using 
      thrombelastography-based platelet functional analysis. RESULTS: There were 51 
      patients in the study. There were significant differences in the platelet 
      response between trauma patients and healthy volunteers, such that there was 
      impaired aggregation to these agonists. In trauma patients, the median ADP 
      inhibition of platelet function was 86.1% (interquartile range [IQR] 38.6% to 
      97.7%) compared with 4.2 % (IQR 0 to 18.2%) in healthy volunteers. After trauma, 
      the impairment of platelet function in response to arachidonic acid was 44.9% 
      (IQR 26.6% to 59.3%) compared with 0.5% (IQR 0 to 3.02%) in volunteers (Wilcoxon 
      nonparametric test, p < 0.0001 for both tests). CONCLUSIONS: In this study, we 
      show that platelet dysfunction is manifest after major trauma and before 
      substantial fluid or blood administration. These data suggest a potential role 
      for early platelet transfusion in severely injured patients at risk for 
      postinjury coagulopathy.
CI  - Copyright (c) 2012 American College of Surgeons. Published by Elsevier Inc. All 
      rights reserved.
FAU - Wohlauer, Max V
AU  - Wohlauer MV
AD  - Department of Surgery, University of Colorado Denver, Denver, CO, USA.
FAU - Moore, Ernest E
AU  - Moore EE
FAU - Thomas, Scott
AU  - Thomas S
FAU - Sauaia, Angela
AU  - Sauaia A
FAU - Evans, Ed
AU  - Evans E
FAU - Harr, Jeffrey
AU  - Harr J
FAU - Silliman, Christopher C
AU  - Silliman CC
FAU - Ploplis, Victoria
AU  - Ploplis V
FAU - Castellino, Francis J
AU  - Castellino FJ
FAU - Walsh, Mark
AU  - Walsh M
LA  - eng
GR  - P50-GM49222/GM/NIGMS NIH HHS/United States
GR  - T32 GM008315/GM/NIGMS NIH HHS/United States
GR  - R56 HL013423/HL/NHLBI NIH HHS/United States
GR  - R37 HL013423/HL/NHLBI NIH HHS/United States
GR  - R01 HL013423/HL/NHLBI NIH HHS/United States
GR  - T32-GM008315/GM/NIGMS NIH HHS/United States
GR  - HL013423/HL/NHLBI NIH HHS/United States
GR  - P50 GM049222/GM/NIGMS NIH HHS/United States
PT  - Controlled Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - J Am Coll Surg
JT  - Journal of the American College of Surgeons
JID - 9431305
SB  - IM
MH  - Adult
MH  - Aged
MH  - Blood Coagulation Disorders/*diagnosis/*epidemiology
MH  - Blood Platelet Disorders/*diagnosis/*epidemiology
MH  - Comorbidity
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multiple Trauma/diagnosis/*epidemiology
MH  - Multivariate Analysis
MH  - Point-of-Care Systems
MH  - Prevalence
MH  - Prospective Studies
MH  - Shock, Hemorrhagic/epidemiology
MH  - Thrombelastography
MH  - Trauma Severity Indices
MH  - Wounds, Nonpenetrating/diagnosis/*epidemiology
MH  - Wounds, Penetrating/diagnosis/*epidemiology
PMC - PMC3348700
MID - NIHMS367120
EDAT- 2012/04/24 06:00
MHDA- 2012/06/12 06:00
PMCR- 2013/05/01
CRDT- 2012/04/24 06:00
PHST- 2011/11/06 00:00 [received]
PHST- 2012/01/09 00:00 [revised]
PHST- 2012/01/09 00:00 [accepted]
PHST- 2012/04/24 06:00 [entrez]
PHST- 2012/04/24 06:00 [pubmed]
PHST- 2012/06/12 06:00 [medline]
PHST- 2013/05/01 00:00 [pmc-release]
AID - S1072-7515(12)00123-8 [pii]
AID - 10.1016/j.jamcollsurg.2012.01.050 [doi]
PST - ppublish
SO  - J Am Coll Surg. 2012 May;214(5):739-46. doi: 10.1016/j.jamcollsurg.2012.01.050.