Disseminated Intravascular Coagulation, Platelet Aggregation, Sepsis, Septic Shock, Thrombocytopenia
Conditions
Brief summary
Coagulation disorders and thrombocytopenia are common in patients with septic shock. Despite the clinical relevance of sepsis-induced thrombocytopenia, few studies have focused on the prediction of thrombocytopenia in this setting. The aim of this study was to evaluate whether platelets aggregometry and markers of platelets activation, such as mean platelet volume or platelet volume distribution width, could predict sepsis-induced thrombocytopenia in patients with septic shock and normal platelet count on the day of diagnosis.
Interventions
DIAGNOSTIC_TESTplatelet responsiveness evaluation
Blood samples were anticoagulated with 0.129 mmol/L of sodium citrate and then centrifugated for 10 min at 200 rpm; platelets aggregation was assessed with an AggRAM Advanced Modular System light transmittance aggregometer (Helena Laboratories, Beaumont, Texas, USA). Low-molecular-weight heparin (LMWH) was given at least 8 hours before any blood aggregation sample. Agonist used to initiate aggregation test were: -Adenosine diphosphate (ADP) to assess P2Y12-dependent platelet aggregation; (20 ng) - Arachidonic acid (AA) to assess cyclooxygenase-dependent platelet Adenosine diphosphate aggregation (1 mcg) - thrombin receptor-activating peptide-6 (TRAP-6) to assess protease-activated receptor 1-dependent platelet aggregation. Max aggregation reached (Aggmax), the slope of the curve (slope) and the latency time (lat) were analyzed for each agonist.
Sponsors
Università degli Studi di Ferrara
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* diagnosis of septic shock * platelet count \>150\*103/mcL.
Exclusion criteria
* age \<18 years * history of any hematologic disorder * chronic liver failure * previous chemotherapy * transfusion of platelet during the previous 4 weeks * renal replacement therapy before ICU admission * history of antiplatelet therapy during the 8 days before inclusion * history of heparin-induced thrombocytopenia (HIT) or other acquired or induced thrombocytopenia * occurrence of HIT (defined as HIT score over 3) * active bleeding
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Occurence of sepsis-induced thrombocytopenia | 5 days after study inclusion | Occurence of platelet count \<150 \*103/μL |
Secondary
| Measure | Time frame |
|---|---|
| life-threatening bleeding | After 28 days from study inclusion |
| 90-day mortality | after 90 days from study enrollment |
| number of Red blood cells (RBC) packs transfused during ICU stay | After 28 days from study inclusion |
Countries
Italy
Outcome results
None listed