-
PloS One 2022Sepsis is a public health problem due to its high prevalence and mortality. Mean platelet volume (MPV), a biomarker reported in routine blood counts, has been...
INTRODUCTION
Sepsis is a public health problem due to its high prevalence and mortality. Mean platelet volume (MPV), a biomarker reported in routine blood counts, has been investigated and shows promise for determining fatal outcomes in septic patients.
OBJECTIVE
Evaluate whether the mean platelet volume (MPV) and mean platelet volume-to-platelet count (MPV/P) ratio are predictors of clinical severity and mortality in patients with sepsis.
METHODS
A prospective population cohort of 163 patients aged 18-97 years was recruited at the Intensive Care Unit of Pablo Arturo Hospital, Quito, Ecuador from 2017-2019 and followed up for 28 days. Patients were diagnosed with sepsis based on SEPSIS-3 septic shock criteria; in which the MPV and the MPV/P ratio were measured on days 1, 2, and 3. Sequential organ failure assessment (SOFA) score and presence of septic shock assessed clinical severity. Mortality on day 28 was considered the fatal outcome.
RESULTS
The average age of the patients was 61,15 years (SD 20,94) and female sex was predominant. MPV cutoff points at days 1, 2 and 3 were >9,45fL, >8,95fL and >8, 85fL; and (MPV/P) ratio >8, 18, >4, 12 y >3, 95, respectively. MPV at days 2 (9,85fL) and 3 (8,55fL) and (MPV/P) ratio at days 1 (4,42), 2 (4,21), and 3 (8,55), were predictors of clinical severity assessed by septic shock, which reached significance in the ROC curves. MPV and (MPV/P) ratio were also predictors of clinical severity determined by SOFA at days 1, 2, and 3, where higher values were observed in non-survivors reaching significance in all categories. MPV and MPV/P ratio at days 1, 2 and 3 were independent predictor factors of mortality using Cox proportional hazards model (HR 2,31; 95% CI 1,36-3,94), (HR 2,11; 95% CI 1,17-3,82), (HR 2,13; 95% CI 1,07-4,21) and (HR 2,38; 95% CI 1,38-4,12), (HR 2,15; 95% CI 1,14-4,06), (HR 4,43; 95% CI, 1,72-11,37) respectively.
CONCLUSIONS
MPV and the MPV/P ratio are predictors of clinical severity and mortality in sepsis. The MPV and its coefficient are indicators of the biological behavior of platelets in sepsis. They should be considered as a cost-effective and rapidly available tool that guides the treatment.
Topics: Aged; Biomarkers; Blood Platelets; Ecuador; Female; Humans; Intensive Care Units; Male; Mean Platelet Volume; Middle Aged; Organ Dysfunction Scores; Platelet Count; Proportional Hazards Models; Prospective Studies; ROC Curve; Shock, Septic
PubMed: 34990467
DOI: 10.1371/journal.pone.0262356 -
Intensive Care Medicine Jun 2020Despite increasing improvement in extracorporeal membrane oxygenation (ECMO) technology and knowledge, thrombocytopenia and impaired platelet function are usual findings... (Meta-Analysis)
Meta-Analysis Review
Despite increasing improvement in extracorporeal membrane oxygenation (ECMO) technology and knowledge, thrombocytopenia and impaired platelet function are usual findings in ECMO patients and the underlying mechanisms are only partially elucidated. The purpose of this meta-analysis and systematic review was to thoroughly summarize and discuss the existing knowledge of platelet profile in adult ECMO population. All studies meeting the inclusion criteria (detailed data about platelet count and function) were selected, after screening literature from July 1975 to August 2019. Twenty-one studies from 1.742 abstracts were selected. The pooled prevalence of thrombocytopenia in ECMO patients was 21% (95% CI 12.9-29.0; 14 studies). Thrombocytopenia prevalence was 25.4% (95% CI 10.6-61.4; 4 studies) in veno-venous ECMO, whereas it was 23.2% (95% CI 11.8-34.5; 6 studies) in veno-arterial ECMO. Heparin-induced thrombocytopenia prevalence was 3.7% (95% CI 1.8-5.5; 12 studies). Meta-regression revealed no significant association between ECMO duration and thrombocytopenia. Platelet function impairment was described in 7 studies. Impaired aggregation was shown in 5 studies, whereas loss of platelet receptors was found in one trial, and platelet activation was described in 2 studies. Platelet transfusions were needed in up to 50% of the patients. Red blood cell transfusions were administered from 46 to 100% of the ECMO patients. Bleeding events varied from 16.6 to 50.7%, although the cause and type of haemorrhage was not consistently reported. Thrombocytopenia and platelet dysfunction are common in ECMO patients, regardless the type of ECMO mode. The underlying mechanisms are multifactorial, and understanding and management are still limited. Further research to design appropriate strategies and protocols for its monitoring, management, or prevention should be matter of thorough investigations.
Topics: Adult; Blood Platelets; Extracorporeal Membrane Oxygenation; Hemorrhage; Humans; Platelet Count; Thrombocytopenia
PubMed: 32328725
DOI: 10.1007/s00134-020-06031-4 -
Neonatology 2021Thrombocytopenia has been identified as an independent risk factor for retinopathy of prematurity (ROP), although underlying mechanisms are unknown. In this study, the...
INTRODUCTION
Thrombocytopenia has been identified as an independent risk factor for retinopathy of prematurity (ROP), although underlying mechanisms are unknown. In this study, the association of platelet count and serum platelet-derived factors with ROP was investigated.
METHODS
Data for 78 infants born at gestational age (GA) <28 weeks were included. Infants were classified as having no/mild ROP or severe ROP. Serum levels of vascular endothelial growth factor A, platelet-derived growth factor BB, and brain-derived neurotrophic factor were measured in serum samples collected from birth until postmenstrual age (PMA) 40 weeks. Platelet counts were obtained from samples taken for clinical indication.
RESULTS
Postnatal platelet counts and serum concentrations of the 3 growth factors followed the same postnatal pattern, with lower levels in infants developing severe ROP at PMA 32 and 36 weeks (p < 0.05-0.001). With adjustment for GA, low platelet counts and low serum concentrations of all 3 factors at PMA 32 weeks were significantly associated with severe ROP. Serum concentrations of all 3 factors also strongly correlated with platelet count (p < 0.001).
CONCLUSION
In this article, we show that ROP, platelet counts, and specific pro-angiogenic factors correlate. These data suggest that platelet-released factors might be involved in the regulation of retinal and systemic angiogenesis after extremely preterm birth. Further investigations are needed.
Topics: Becaplermin; Brain-Derived Neurotrophic Factor; Female; Gestational Age; Humans; Infant; Infant, Extremely Premature; Infant, Newborn; Platelet Count; Pregnancy; Premature Birth; Retinopathy of Prematurity; Risk Factors; Vascular Endothelial Growth Factor A
PubMed: 33611321
DOI: 10.1159/000512282 -
International Journal of Laboratory... Feb 2023The aim of this study performed on Sysmex XN is to compare platelet values on citrate and MgSO (TBX) in patients with K2EDTA-induced platelet clusters and to identify...
INTRODUCTION
The aim of this study performed on Sysmex XN is to compare platelet values on citrate and MgSO (TBX) in patients with K2EDTA-induced platelet clusters and to identify platelet biases of these matrices compared to K2EDTA.
METHODS
Sixty patients with K2EDTA-induced platelet clusters were re-sampled with K2EDTA, citrate and TBX. Platelet results were then compared, and smears were analysed for clumping. Platelet results from 120 patients without K2EDTA-induced platelet clusters were compared between K2 EDTA, citrate, and MgSO with impedance and fluorescence modes. Biases from regressions were analysed.
RESULTS
Out of the 60 patients with K2EDTA-induced platelet clusters, none showed platelet clusters with MgSO whereas 50% still showed clusters with citrate. Among those without platelet clusters on citrate, the mean relative difference between (citrate- MgSO )/MgSO was -12.7% in impedance and -9.8% in fluorescence. Among the 120 patients without K2EDTA-induced platelet clusters, in fluorescence the mean relative bias with respect to K2EDTA was -2.06% for MgSO and -10.3% for Citrate. For the MgSO versus K2 EDTA regressions, the maximum absolute values of the 95% CI of the relative biases at 150 × 10 /L (5.45%) and 450 × 10 /L (3.56%) were below the desirable analytical objectives of the EFLM.
CONCLUSION
In patients with K2EDTA-induced platelet clusters, MgSO is preferable to citrate. MgSO provides a bias with XN in fluorescence when compared to EDTA which is within analytical tolerance.
Topics: Humans; Platelet Count; Anticoagulants; Edetic Acid; Citric Acid; Blood Platelets
PubMed: 36093831
DOI: 10.1111/ijlh.13966 -
Experimental and Clinical... Feb 2021Thrombocytopenia is a common problem among liver transplant recipients. However, various patterns of change in platelet counts during adult liver transplant have been...
OBJECTIVES
Thrombocytopenia is a common problem among liver transplant recipients. However, various patterns of change in platelet counts during adult liver transplant have been reported in the literature. This study aimed to evaluate alterations in platelet count according to the surgical phase (preanhepatic, anhepatic, after reperfusion) and during the early postoperative period of liver transplant.
MATERIALS AND METHODS
Perioperative data from 100 patients undergoing deceased donor liver transplant were reviewed, including platelet count-related data. Platelet counts were measured at predefined time points throughout the procedure: immediately before induction of anesthesia, at the early neo-hepatic stage (10 min after graft reperfusion), immediately after admission to the intensive care unit posttransplant, and 6 hours posttransplant. Platelet counts were then measured daily during stay in the intensive care unit.
RESULTS
Mean baseline platelet count before transplant and anesthesia was 97.92 × 109/L. A peak platelet count was seen in the early neo-hepatic stage. Platelet counts then decreased sharply in the first 6 hours after transplant. A slight decrease in platelet counts continued until the third day after the surgery; finally, on day 6 posttransplant, platelet counts increased significantly.
CONCLUSIONS
Our study showed a significant sudden increase in platelet counts during the early neo-hepatic phase in many liver transplant recipients. Therefore, our results suggest that it is reasonable to avoid platelet transfusion for most liver transplant recipients during transplant surgery.
Topics: Humans; Liver Transplantation; Perioperative Period; Platelet Count; Platelet Transfusion; Thrombocytopenia
PubMed: 33605209
DOI: 10.6002/ect.2020.0195 -
International Journal of Clinical... 2022Mean platelet volume (MPV) is a marker used to assess the platelet' size and is also an indicator of platelet reactivity and prothrombotic status.
INTRODUCTION
Mean platelet volume (MPV) is a marker used to assess the platelet' size and is also an indicator of platelet reactivity and prothrombotic status.
OBJECTIVE
In this study, we aimed to determine the relationship between MPV and biochemical parameters in patients who had received hemodialysis (HD) for the first time and then in respect of those same patients after their fourth HD.
METHOD
151 HD patients were enrolled in this study. Patients were eligible for inclusion if they had received their first HD session during this study protocol. Prehemodialysis blood samples were taken. Most laboratory values, including mean platelet volume (MPV) level and platelets (PLT) count, were measured before the first HD and after the fourth HD session for each patient.
RESULTS
Among the patients in our study, the mean age profile of the male patients ( = 103; 68.2%) was found to be higher than that of the female patients ( = 48; 31.8%) (53.62 ± 18.19 vs. 46.17 ± 17.9 years) ( = 0.019).In the patients' laboratory results after the fourth HD session, MPV, MPV/Plt, and Na values had increased to those after the first HD session ( < 0.001). When age and gender status were taken into account, the level of weak positive correlation with white blood cell count (WBC), neutrophil, and red cell distribution width (RDW) was found, while the weak negative correlation with platelet to lymphocyte ratio (PLR) was found ( < 0.001).
CONCLUSIONS
In our study, we found that increase in MPV and MPV/PLT levels was significant in the fourth HD session of patients with CKD. It is also debatable that there are findings indicating an increase in platelet reactivity in the first weeks of the onset of HD. This could be an early indicator of the early prevention of cardiovascular diseases.
Topics: Female; Humans; Leukocyte Count; Male; Mean Platelet Volume; Platelet Count; Renal Dialysis; Retrospective Studies; Somalia
PubMed: 35832803
DOI: 10.1155/2022/1503227 -
Blood Apr 2024Platelet count reduction occurs throughout pregnancy, with 5% to 12% of pregnant women being diagnosed with gestational thrombocytopenia (GT), characterized by a more...
Platelet count reduction occurs throughout pregnancy, with 5% to 12% of pregnant women being diagnosed with gestational thrombocytopenia (GT), characterized by a more marked decrease in platelet count during pregnancy. However, the underlying biological mechanism behind these phenomena remains unclear. Here, we used sequencing data from noninvasive prenatal testing of 100 186 Chinese pregnant individuals and conducted, to our knowledge, the hitherto largest-scale genome-wide association studies on platelet counts during 5 periods of pregnancy (the first, second, and third trimesters, delivery, and the postpartum period) as well as 2 GT statuses (GT platelet count < 150 × 109/L and severe GT platelet count < 100 × 109/L). Our analysis revealed 138 genome-wide significant loci, explaining 10.4% to 12.1% of the observed variation. Interestingly, we identified previously unknown changes in genetic effects on platelet counts during pregnancy for variants present in PEAR1 and CBL, with PEAR1 variants specifically associated with a faster decline in platelet counts. Furthermore, we found that variants present in PEAR1 and TUBB1 increased susceptibility to GT and severe GT. Our study provides insight into the genetic basis of platelet counts and GT in pregnancy, highlighting the critical role of PEAR1 in decreasing platelet counts during pregnancy and the occurrence of GT. Those with pregnancies carrying specific variants associated with declining platelet counts may experience a more pronounced decrease, thereby elevating the risk of GT. These findings lay the groundwork for further investigation into the biological mechanisms and causal implications of GT.
Topics: Pregnancy; Female; Humans; Platelet Count; Genome-Wide Association Study; Pregnancy Complications, Hematologic; Thrombocytopenia; Postpartum Period; Receptors, Cell Surface
PubMed: 38064665
DOI: 10.1182/blood.2023021925 -
Acta Veterinaria Scandinavica Dec 2021Primary immune thrombocytopenia (ITP) is a cause of severe thrombocytopenia in dogs. Immunosuppressive corticosteroid drugs are frequently used in the management of ITP,... (Review)
Review
Primary immune thrombocytopenia (ITP) is a cause of severe thrombocytopenia in dogs. Immunosuppressive corticosteroid drugs are frequently used in the management of ITP, but treatment failure may occur. Immunomodulatory and non-corticosteroid immunosuppressive drugs might improve outcomes from therapy either alone or in combination with corticosteroids. The objectives of this scoping review were (1) to evaluate the current evidence relating to immunomodulatory and immunosuppressive drug protocols in the treatment of canine ITP, and (2) to answer the clinical question, whether or not therapy with immunomodulatory or non-corticosteroid immunosuppressive drugs alone or in combination with corticosteroids could improve outcome, compared to therapy with corticosteroids alone. A literature search was performed in the electronic databases of Agricola, CAB Abstracts, Embase, Medline and Web of Science for publications in November 2019 and again February 1, 2021. Selection criteria were relatively strict and included peer-reviewed research papers reporting outcome measures from immunomodulatory and immunosuppressive drug protocols in the treatment of canine ITP with a pre-therapeutic mean or median platelet count < 50,000/µL as a strict criterion for inclusion. Studies were evaluated if they had an appropriate diagnostic work up to exclude underlying conditions. Outcome measures and adverse events were compared between drug protocols both within studies and between studies. The search identified 456 studies, with six studies being eligible for inclusion. The studies were mostly case series while two were randomized controlled trials. Level of evidence varied with an overall uncertain subject enrollment, small groups, inadequate description and variable use of drug protocols or outcome measures. For outcomes such as platelet recovery time and duration of hospitalization, an improvement was observed using adjunctive therapy (human intravenous immunoglobulin) compared to therapy with corticosteroids alone. For outcomes of complete platelet recovery time, survival (6-month), mortality and relapse, no improvement was observed using adjunctive drugs compared to corticosteroids alone. Specifically, therapy with mycophenolate mofetil alone and adjunctive azathioprine were associated with more severe adverse events compared to other drug protocols. Evidence relating to immunomodulatory and immunosuppressive drug protocols in the treatment of canine ITP was of variable quality. Future larger case-controlled trials are required for determination of optimal treatment protocols in canine ITP.
Topics: Animals; Blood Platelets; Dog Diseases; Dogs; Immunosuppressive Agents; Pharmaceutical Preparations; Platelet Count; Purpura, Thrombocytopenic, Idiopathic
PubMed: 34961516
DOI: 10.1186/s13028-021-00620-z -
Annals of Laboratory Medicine Sep 2023Delta checks increase patient safety by identifying automated hematology analyzer errors. International standards and guidelines for the complete blood count (CBC) delta...
BACKGROUND
Delta checks increase patient safety by identifying automated hematology analyzer errors. International standards and guidelines for the complete blood count (CBC) delta check method have not been established. We established an effective, practical CBC delta check method and criteria.
METHODS
We assessed five delta check methods for nine CBC items (Hb, mean corpuscular volume, platelet count, white blood cell [WBC] count, and five-part WBC differential counts) using 219,804 blood samples from outpatients and inpatients collected over nine months. We adopted the best method and criteria and evaluated them using 42,652 CBC samples collected over two weeks with a new workflow algorithm for identifying test errors and corrections for Hb and platelet count.
RESULTS
The median delta check time interval was 1 and 21 days for inpatients and outpatients (range, 1-20 and 1-222 days), respectively. We used delta values at 99.5% as delta check criteria; the criteria varied among the five methods and between outpatients and inpatients. The delta percent change (DPC)/reference range (RR) rate performed best as the delta check for CBC items. Using the new DPC/RR rate method, 1.7% of total test results exceeded the delta check criteria; the retesting and resampling rates were 0.5% and 0.001%, respectively.
CONCLUSIONS
We developed an effective, practical delta check method, including RRs and delta check time intervals, and delta check criteria for nine CBC items. The criteria differ between outpatients and inpatients. Using the new workflow algorithm, we can identify the causes of criterion exceedance and report correct test results.
Topics: Humans; Blood Cell Count; Leukocyte Count; Platelet Count; Quality Control; Hematology
PubMed: 37080742
DOI: 10.3343/alm.2023.43.5.418 -
Brain and Behavior May 2024The purpose of this study was to investigate the predictive value of mean platelet volume (MPV) and platelet count (PC) in branch atheromatous disease (BAD).
OBJECTIVE
The purpose of this study was to investigate the predictive value of mean platelet volume (MPV) and platelet count (PC) in branch atheromatous disease (BAD).
METHODS
This retrospective study included 216 patients with BAD-stroke within 48 h of symptom onset. These patients were divided into good and poor prognosis groups according to their 3-month modified Rankin scale scores after discharge. Multiple logistic regression analysis was used to evaluate independent predictors of poor prognosis in BAD-stroke patients. Receiver-operating characteristic (ROC) analysis was used to estimate the predictive value of MPV and PC on BAD-stroke.
RESULTS
Our research showed that a higher MPV (aOR, 2.926; 95% CI, 2.040-4.196; p < .001) and PC (aOR, 1.013; 95% CI, 1.005-1.020; p = .001) were independently associated with poor prognosis after adjustment for confounders. The ROC analysis of MPV for predicting poor prognosis showed that the sensitivity and specificity were 74% and 84.9%, respectively, and that the AUC was .843 (95% CI, .776-.909, p < .001). The optimal cut-off value was 12.35. The incidence of early neurological deterioration (END) was 24.5% (53 of 163), and 66% of patients in the poor prognosis group had END (33 of 50). Multiple logistic regression analyses showed that elevated MPV and PC were associated with the occurrence of END (p < .05).
CONCLUSION
Our results suggested that an elevated MPV and PC may be important in predicting a worse outcome in BAD-stroke patients. Our study also demonstrated an independent association of MPV and PC with END, which is presumably the main reason for the poor prognosis.
Topics: Humans; Male; Female; Mean Platelet Volume; Prognosis; Retrospective Studies; Middle Aged; Aged; Platelet Count; Stroke; Plaque, Atherosclerotic
PubMed: 38779748
DOI: 10.1002/brb3.3509