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Seminars in Thrombosis and Hemostasis Apr 2020Extracorporeal membrane oxygenation (ECMO) is a form of life support used to treat neonates, children, and adults with cardiorespiratory failure refractory to... (Review)
Review
Extracorporeal membrane oxygenation (ECMO) is a form of life support used to treat neonates, children, and adults with cardiorespiratory failure refractory to conventional therapy. This therapy requires the use of anticoagulation to prevent clotting in the extracorporeal circuit, but anticoagulation also increases the risk of bleeding on ECMO. Both bleeding and thrombosis remain significant complications on ECMO and balancing these risks is challenging. Acquired platelet dysfunction is common during ECMO and quantitative and qualitative platelet dysfunction contributes to bleeding risk. Optimal platelet count, function, and transfusion thresholds are not well established during pediatric ECMO. In this review, we provide an overview of hemostatic alterations during ECMO, changes in platelet count and function, platelet monitoring techniques, bleeding risk, and future needs to best optimize patient management and care.
Topics: Blood Coagulation; Extracorporeal Membrane Oxygenation; Humans; Platelet Count
PubMed: 32232826
DOI: 10.1055/s-0040-1708542 -
Emergency Medicine Clinics of North... Feb 1986An estimate of the platelet count is usually given as part of the complete blood count (CBC). It should not be neglected when reviewing CBC results as it is a fair... (Review)
Review
An estimate of the platelet count is usually given as part of the complete blood count (CBC). It should not be neglected when reviewing CBC results as it is a fair screening test and satisfactory for most purposes in the emergency department. It is a quantitative study, and the functional status of the platelet must always be considered in interpretation of clinical significance. Patients presenting with abnormal bleeding histories, particularly women with mucosal origin bleeding, should have an evaluation of platelet quantity by an accurate method and functional quality by a bleeding time. Though rarely used, the emergency physician should be familiar with the indication and mechanics of platelet transfusions. The laboratory charge for the platelet count is $17.00 to 18.00, whether it is automated or hand counted.
Topics: Adult; Blood Platelets; Diagnosis, Differential; Electronics, Medical; Emergencies; Female; Humans; Male; Middle Aged; Platelet Count; Thrombocytopenia; Thrombocytosis
PubMed: 3512247
DOI: No ID Found -
Platelets Mar 2018The last decade has witnessed an explosion in the depth, variety, and amount of human genetic data that can be generated. This revolution in technical and analytical... (Review)
Review
The last decade has witnessed an explosion in the depth, variety, and amount of human genetic data that can be generated. This revolution in technical and analytical capacities has enabled the genetic investigation of human traits and disease in thousands to now millions of participants. Investigators have taken advantage of these advancements to gain insight into platelet biology and the platelet's role in human disease. To do so, large human genetics studies have examined the association of genetic variation with two quantitative traits measured in many population and patient based cohorts: platelet count (PLT) and mean platelet volume (MPV). This article will review the many human genetic strategies-ranging from genome-wide association study (GWAS), Exomechip, whole exome sequencing (WES), to whole genome sequencing (WGS)-employed to identify genes and variants that contribute to platelet traits. Additionally, we will discuss how these investigations have examined and interpreted the functional implications of these newly identified genetic factors and whether they also impart risk to human disease. The depth and size of genetic, phenotypic, and other -omic data are primed to continue their growth in the coming years and provide unprecedented opportunities to gain critical insights into platelet biology and how platelets contribute to disease.
Topics: Blood Platelets; Female; Humans; Male; Mean Platelet Volume; Platelet Count
PubMed: 28649937
DOI: 10.1080/09537104.2017.1317732 -
Platelets May 2021The relationship between platelet count and risk of major bleeding in patients with venous thromboembolism (VTE) during anticoagulation remains unclear. We therefore...
The relationship between platelet count and risk of major bleeding in patients with venous thromboembolism (VTE) during anticoagulation remains unclear. We therefore investigated the association between platelet count, measured at VTE diagnosis and before the thrombotic event, and risk of major bleeding. Participants comprised 744 patients with incident VTE derived from the Tromsø Study. Major bleedings were recorded during the first year after VTE. Cox-regression was used to calculate hazard ratios (HRs) for major bleeding across platelet count quartiles.There were 55 major bleedings (incidence rate 9.1/100 person-years, 95% confidence interval [CI] 7.0-11.8). The major bleeding risk increased across quartiles of platelet count measured at VTE diagnosis ( for trend<0.02). In the age- and sex-adjusted model, subjects with platelet count in the highest quartile (≥300x10/L) had a 4.3-fold (95% CI 1.7-10.9) higher risk of major bleeding compared to those with platelet count in the lowest quartile (≤192x10/L), and exclusion of patients with cancer yielded similar results. When platelet count was measured on average 7 years before a VTE, the corresponding HR was 2.5 (95% CI 0.9-6.7). Our results suggest that increasing platelet count, assessed several years before and at VTE diagnosis, is associated with a higher risk of major bleeding, and could be a stable individual marker of major bleeding risk in VTE-patients.
Topics: Adult; Aged; Aged, 80 and over; Female; Hemorrhage; Humans; Male; Middle Aged; Platelet Count; Risk Factors; Venous Thromboembolism
PubMed: 32498591
DOI: 10.1080/09537104.2020.1769052 -
Platelets 2020Alcohol inhibits platelet function, and platelet count is often reduced in individuals with alcohol use disorder. However, the relation of habitual alcohol drinking with...
Alcohol inhibits platelet function, and platelet count is often reduced in individuals with alcohol use disorder. However, the relation of habitual alcohol drinking with platelet count in a general population remains to be determined. The participants were 6508 men (30 ~ 69 years old) who had received annual health checkup examinations, and most of them (98.6%) were nondrinkers or drinkers with an average ethanol intake of less than 66 g per day. Relationships of platelet count with alcohol intake were investigated by using analysis of covariance and multivariate linear and logistic regression analyses. Platelet count was significantly correlated with age, smoking, γ-glutamyl transpeptidase, body mass index and leukocyte count, which were thus used as explanatory variables in the multivariate analyses. Mean platelet counts in light (<22 g of ethanol per day), moderate (≥22 and <44 g ethanol per day) and heavy (≥44 g ethanol per day) drinkers were not significantly different from that in nondrinkers. Odds ratios vs. nondrinkers of light, moderate and heavy drinkers for low platelet count (<15 x 10/μl) were not significantly different from the reference level. In conclusion, there is no association between habitual alcohol drinking and platelet count in a general population. Further studies using data for heavier drinkers are needed to confirm the relationship between alcohol use disorder and platelet count.
Topics: Adult; Aged; Alcohol Drinking; Humans; Male; Middle Aged; Platelet Count
PubMed: 31269404
DOI: 10.1080/09537104.2019.1636022 -
Clinical Laboratory Apr 2022Changes in platelet count are associated with a variety of diseases and treatments. Measuring it gives better insight into the expected outcome. Our aim was to evaluate...
BACKGROUND
Changes in platelet count are associated with a variety of diseases and treatments. Measuring it gives better insight into the expected outcome. Our aim was to evaluate the accuracy of three methods for platelet count in hyperlipidemia samples.
METHODS
Sixty non-lipid whole bloods from 60 individuals were included: 20 in low platelet count group, 20 in medium platelet count group, and 20 in high platelet count group. Then, 400 μL plasma was exchanged with 400 μL fat emulsion. Platelet count was measured after replacement by three methods, impedance method (Plt-I), optical method (Plt-O), and fluorescence method (Plt-F).
RESULTS
In the low platelet count group with fat emulsion plasma exchange, except for Plt-O, other methods showed the predefined acceptance criterion (± 10%) covered the mean bias and 95% CI of proportional bias (slope) which were obtained from Bland-Altman plot and Passing-Bablok algorithm, respectively. In medium and high platelet count group with fat emulsion plasma exchange, the predefined acceptance mean bias and criterion of 95% CI of proportional bias (slope) and intercept were met only in Plt-F. In the medium platelet count group, the mean bias was -1.600% and the 95%CI of slope and intercept were 1.000 (0.815 to 1.071) and -0.500 (-12.831 to 23.907), respectively. In the high platelet count group, the mean bias was -2.250% and the 95%CI of slope and intercept were 1.071 (0.974 to 1.225) and -33.8142 (-113.703 to 8.339), respectively.
CONCLUSIONS
Our results show that the Plt-F can more accurately reflect the true platelet count of lipemia specimens compared with Plt-I or Plt-O.
Topics: Blood Platelets; Emulsions; Hematologic Diseases; Humans; Hyperlipidemias; Platelet Count
PubMed: 35443598
DOI: 10.7754/Clin.Lab.2021.210708 -
Platelets Jul 2021Platelet function in neonates is sparsely investigated. The majority of previous studies investigated platelets in umbilical cord (UC) blood rather than in peripheral...
Platelet function in neonates is sparsely investigated. The majority of previous studies investigated platelets in umbilical cord (UC) blood rather than in peripheral blood.We included 20 term neonates and sampled UC blood and peripheral blood within 20 min and 24 h after birth. Platelet count and mean platelet volume (MPV) were measured. Platelet surface glycoproteins (GP) and platelet activation (bound fibrinogen, CD63 and -selectin) after agonist stimulation were examined by flow cytometry. Platelet aggregation was evaluated by impedance aggregometry. The significance level was set after Bonferroni correction.Platelet count and MPV did not differ between UC and peripheral blood (-values >0.08). Expression of platelet surface GP was similar in UC and peripheral blood (all -values >0.02). Platelet activation was lower in UC blood than in peripheral blood for bound fibrinogen (four out of eight -values <0.001) but did not differ for CD63 (all -values >0.01) or -selectin (all -values >0.01). Platelet aggregation was significantly higher in UC than in peripheral blood (-values <0.001).In conclusion, platelet count, MPV and expression of platelet surface GP measured in term neonatal UC blood represented that of peripheral blood. Platelet activation and aggregation in UC blood did not reflect that of peripheral blood.
Topics: Blood Platelets; Cohort Studies; Female; Fetal Blood; Humans; Infant, Newborn; Male; Platelet Count; Prospective Studies
PubMed: 32631163
DOI: 10.1080/09537104.2020.1786040 -
JAMA Network Open Jan 2022Individuals with cancer often have an elevated platelet count at the time of diagnosis. The extent to which an elevated platelet count is an indicator of cancer is...
IMPORTANCE
Individuals with cancer often have an elevated platelet count at the time of diagnosis. The extent to which an elevated platelet count is an indicator of cancer is unclear.
OBJECTIVE
To evaluate the association of an elevated platelet count with a cancer diagnosis.
DESIGN, SETTING, AND PARTICIPANTS
This nested case-control study included Ontario residents enrolled in the provincial health insurance plan who had 1 or more routine complete blood count (CBC) tests performed between January 1, 2007, and December 31, 2017, with follow-up through December 31, 2018. Case patients were individuals with a new cancer diagnosis during the observation period. Eligible control individuals were cancer free before the date of diagnosis for a case patient to whom they were matched. One case patient was matched to 3 controls based on sex, age, and health care use patterns. Data were analyzed from September 24, 2020, to July 13, 2021.
EXPOSURES
Case patients and controls were assigned to 1 of 5 exposure groups based on age- and sex-specific platelet count distributions in the control population: very low (≤10th percentile), low (>10th to 25th percentile), medium (>25th to <75th percentile), high (75th to <90th percentile), and very high (≥90th percentile).
MAIN OUTCOMES AND MEASURES
Odds ratios (ORs) were estimated for specific cancer sites for each category of platelet count at intervals up to 10 years after a blood test.
RESULTS
Of the 8 917 187 eligible Ontario residents with a routine CBC record available, 4 971 578 (55.8%) were women; the median age at the first CBC was 46.4 years (IQR, 32.5-59.5 years). Among individuals with a routine CBC record available, 495 341 (5.6%) received a diagnosis of first primary cancer during the 10-year observation period. The OR for a solid tumor diagnosis associated with a very high platelet count vs a medium platelet count in the 6-month period before the diagnosis was 2.32 (95% CI, 2.28-2.35). A very high platelet count was associated with colon (OR, 4.38; 95% CI, 4.22-4.54), lung (OR, 4.37; 95% CI, 4.22-4.53), ovarian (OR, 4.62; 95% CI, 4.19-5.09), and stomach (OR, 4.27; 95% CI, 3.91-4.66) cancers. Odds ratios attenuated with increasing time from CBC test to cancer diagnosis.
CONCLUSIONS AND RELEVANCE
In this nested case-control study, an elevated platelet count was associated with increased risk of cancer at several sites. Our findings suggest that an elevated platelet count could potentially serve as a marker for the presence of some cancer types.
Topics: Adult; Biomarkers; Case-Control Studies; Female; Humans; Male; Middle Aged; Neoplasms; Ontario; Platelet Count
PubMed: 35015064
DOI: 10.1001/jamanetworkopen.2021.41633 -
Journal of Cardiothoracic and Vascular... Jun 2019
Topics: Blood Coagulation; Electrodes; Platelet Count; Thrombelastography; Ultrasonic Waves
PubMed: 30928280
DOI: 10.1053/j.jvca.2019.02.038 -
Transfusion and Apheresis Science :... Jun 2024While there are various aspects of platelet biology that can be studied in the lab (i.e. adhesion, degranulation, integrin activation), the master test for platelet... (Review)
Review
While there are various aspects of platelet biology that can be studied in the lab (i.e. adhesion, degranulation, integrin activation), the master test for platelet function is that which gives a measure of the platelet aggregation capacity upon stimulation with an agonist. Platelet function testing is necessary for the diagnosis of platelet disorders and the monitoring of patients receiving anti-platelet treatments. Furthermore, it becomes relevant in the quality control of platelet concentrates for transfusion purposes, especially considering the global concern about long term storage, other forms of storage (i.e. cryopreservation, lyophilization), and the impact of Pathogen Reduction Treatments (PRTs) on platelet performance upon transfusion. However, it has been acknowledged as technically difficult and demanding, since a fine platelet function test must be carried out under specific conditions. Still, there might be occasions that preclude the platelet function testing abiding to the gold standard requirements, thus, leaving us with the necessity to redefine which variables may condition or limit the analysis of platelet function testing. In the present manuscript, we test different variables (such as the anticoagulant used or the time elapsed since extraction) and the possibility to reconstitute blood prior to platelet function analysis. This study aims to provide windows of action at the diagnostics lab, especially when not all of the recommended procedures and conditions can be followed: for example, when a sample is sent from a long distance, when there is a limitation on blood extraction volume or when certain parameters (platelet count) preclude reliable test results.
Topics: Humans; Platelet Function Tests; Platelet Count; Blood Platelets
PubMed: 38644062
DOI: 10.1016/j.transci.2024.103930