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01.04.2013 | Original Article

Platelet Dysfunction is an Early Marker for Traumatic Brain Injury-Induced Coagulopathy

verfasst von: Patrick K. Davis, Harsha Musunuru, Mark Walsh, Robert Cassady, Robert Yount, Andrew Losiniecki, Ernest E. Moore, Max V. Wohlauer, Janet Howard, Victoria A. Ploplis, Francis J. Castellino, Scott G. Thomas

Erschienen in: Neurocritical Care | Ausgabe 2/2013

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Abstract

Background

The goal of this study is to determine the presence of platelet dysfunction in patients with traumatic brain injury (TBI). The mechanisms underlying the coagulopathy associated with TBI remain elusive. The question of platelet dysfunction in TBI is unclear.

Methods

This was a prospective observational study conducted at Memorial Hospital of South Bend, IN, and Denver Health Medical Center, CO. A total of 50 patients sustaining TBI, and not under treatment with anticoagulants or platelet inhibitors, were analyzed utilizing modified thromboelastography (TEG) with platelet mapping (TEG/PM), along with standard coagulation tests.

Results

Compared to normal controls, patients with severe TBI had a significantly increased percentage of platelet ADP and arachidonic acid (AA) receptor inhibition. Furthermore, the percentage of ADP inhibition distinguished between survivors and non-survivors in patients with TBI (Mann–Whitney test, P = 0.035). ADP inhibition correlates strongly with severity of TBI (Mann–Whitney test, P = 0.014), while AA inhibition did not.

Conclusion

These data indicate that early platelet dysfunction is prevalent after severe TBI, can be measured in a point-of-care setting using TEG/PM, and correlates with mortality. The mechanism responsible for this platelet dysfunction and associated implications for TBI management remains to be defined.

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Titel: Platelet Dysfunction is an Early Marker for Traumatic Brain Injury-Induced Coagulopathy
verfasst von: Patrick K. Davis
Harsha Musunuru
Mark Walsh
Robert Cassady
Robert Yount
Andrew Losiniecki
Ernest E. Moore
Max V. Wohlauer
Janet Howard
Victoria A. Ploplis
Francis J. Castellino
Scott G. Thomas
Publikationsdatum: 01.04.2013
Verlag: Humana Press Inc
Erschienen in: Neurocritical Care / Ausgabe 2/2013
Print ISSN: 1541-6933
Elektronische ISSN: 1556-0961
DOI: https://doi.org/10.1007/s12028-012-9745-6

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Platelet Dysfunction is an Early Marker for Traumatic Brain Injury-Induced Coagulopathy

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Background

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Conclusion

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