2 Platelet Concentrates

Schlenke, Peter; Sibrowski, W.

doi:10.1159/000268058

Cited by 12 publications

(3 citation statements)

References 63 publications

(77 reference statements)

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“…Guidelines suggest platelet thresholds should be higher than 20 × 10 9 /L or 50 × 10 9 /L for lumbar puncture and INR levels lower than 1.5 for removal of epidural catheters. 13,[31][32][33][34] However, some experts recommend proceeding with lumbar puncture regardless of coagulation status if the medical indication is acute bacterial meningitis. 35…”

Section: Discussionmentioning

confidence: 99%

Association of Lumbar Puncture With Spinal Hematoma in Patients With and Without Coagulopathy

Bodilsen

Mariager

Vestergaard

et al. 2020

JAMA

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IMPORTANCE Coagulopathy may deter physicians from performing a lumbar puncture.OBJECTIVE To determine the risk of spinal hematoma after lumbar puncture in patients with and without coagulopathy.DESIGN, SETTING, AND PARTICIPANTS Danish nationwide, population-based cohort study using medical registries to identify persons who underwent lumbar puncture and had cerebrospinal fluid analysis (January 1, 2008-December 31, 2018; followed up through October 30, 2019). Coagulopathy was defined as platelets lower than 150 × 10 9 /L, international normalized ratio (INR) greater than 1.4, or activated partial thromboplastin time (APTT) longer than 39 seconds.EXPOSURES Coagulopathy at the time of lumbar puncture.MAIN OUTCOMES AND MEASURES Thirty-day risk of spinal hematoma. Risks were provided as numbers and percentages with 95% CIs. Secondary analyses included risks of traumatic lumbar puncture (>300 × 10 6 erythrocytes/L after excluding patients diagnosed with subarachnoid hemorrhage). Adjusted hazard rate ratios (HRs) were computed using Cox regression models.RESULTS A total of 83 711 individual lumbar punctures were identified among 64 730 persons (51% female; median age, 43 years [interquartile range, 22-62 years]) at the time of the procedure. Thrombocytopenia was present in 7875 patients (9%), high INR levels in 1393 (2%), and prolonged APTT in 2604 (3%). Follow-up was complete for more than 99% of the study participants. Overall, spinal hematoma occurred within 30 days for 99 of 49 526 patients (0.20%; 95% CI, 0.16%-0.24%) without coagulopathy vs 24 of 10 371 patients (0.23%; 95% CI, 0.15%-0.34%) with coagulopathy. Independent risk factors for spinal hematoma were male sex (adjusted hazard ratio [HR], 1.72; 95% CI, 1.15-2.56), those aged 41 through 60 years (adjusted HR, 1.96; 95% CI, 1.01-3.81) and those aged 61 through 80 years (adjusted HR, 2.20; 95% CI, 1.12-4.33). Risks did not increase significantly according to overall severity of coagulopathy, in subgroup analyses of severity of coagulopathy by pediatric specialty or medical indication (infection, neurological condition, and hematological malignancy), nor by cumulative number of procedures. Traumatic lumbar punctures occurred more frequently among patients with INR levels of 1.5 to 2.0 (36.8%; 95% CI, 33.3%-40.4%), 2.1 to 2.5 (43.7%; 95% CI, 35.8%-51.8%), and 2.6 to 3.0 (41.9% 95% CI 30.5-53.9) vs those with normal INR (28.2%; 95% CI, 27.7%-28.75%). Traumatic spinal tap occurred more often in patients with an APTT of 40 to 60 seconds (26.3%; 95% CI, 24.2%-28.5%) vs those with normal APTT (21.3%; 95% CI, 20.6%-21.9%) yielding a risk difference of 5.1% (95% CI, 2.9%-7.2%). CONCLUSIONS AND RELEVANCEIn this Danish cohort study, risk of spinal hematoma following lumbar puncture was 0.20% among patients without coagulopathy and 0.23% among those with coagulopathy. Although these findings may inform decision-making about lumbar puncture by describing rates in this sample, the observed rates may reflect bias due to physicians selecting relatively low-risk patients for ...

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Section: Discussionmentioning

confidence: 99%

Association of Lumbar Puncture With Spinal Hematoma in Patients With and Without Coagulopathy

Bodilsen

Mariager

Vestergaard

et al. 2020

JAMA

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“…Эффективность применения концентратов тромбоцитов для профилактики и лечения кровотечений зависит от методов их получения, сроков и условий хранения [12]. Есть два основных способа получения донорских тромбоцитов: метод цитафереза c использованием специальных сепараторов крови и центрифугирование стабилизированной цельной крови.…”

Section: актуальностьunclassified

“…Изолированные тромбоциты суспендируют или в нативной плазме крови, или в плазме, разбавленной солевым раствором, до концентрации клеток не менее 1-2×10 6 /мкл [13]. После приготовления концентраты тромбоцитов, как правило, хранят при температуре 20-24 °C при постоянном покачивании в ёмкостях из специального материала, который обеспечивает газообмен с атмосферой [12][13][14][15].…”

Section: актуальностьunclassified

Morphofunctional state of platelets in their concentrates depending on storage time

Khabirova

Fatkhullina²,

Andrianova³

et al. 2023

Kazan Med J

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Background.Evaluation of the functional state of platelets in the composition of concentrates is necessary to improve the methods of their production, optimize storage conditions and terms, increase therapeutic efficacy, and reduce the risk of transfusion complications. Aim.Comprehensive study of the morphofunctional state of platelets during the storage of their concentrates. Material and methods.202samples of human platelet apheresis concentrates were studied for storage periods of up to 17days at a temperature of 2224C. The functional state of platelets was assessed using flow cytometry for the expression of P-selectin, active IIb3 integrin, and phosphatidylserines before and after biochemical stimulation. In addition, the mitochondrial potential of platelets, the concentration of intracellular adenosine triphosphate, contractile properties, induced aggregation, and morphological characteristics were studied according to scanning electron microscopy. Statistical analysis was performed by analysis of variance (ANOVA or KruskalWallis). Results.In non-activated platelets during storage, the spontaneous expression of P-selectin increased by an average of 7times, and phosphatidylserines by 3times. The induced expression of P-selectin, integrin IIb3 and phosphatidylserines was the highest on the day of receiving the concentrate and gradually decreased during storage to 1/2of the initial level. Platelet aggregation activity in response to collagen stimulation progressively decreased by an average of 100times, in response to the TRAP peptide by 1.5times. In contrast to the expression of activation markers, the ability of platelets to compress plasma clots in most samples changed slightly, within a few percent; in single samples, the contractile function dropped to zero by 47days of storage, which was combined with platelet hyperactivation and depletion. The mitochondrial potential of platelets and the content of adenosine triphosphate were relatively constant. Morphologically, discoid platelets predominated, however, starting from the 1st day of storage, spindle-shaped platelets, and from the 3rd day spherical forms and microaggregates of platelets accumulated. Conclusion.Platelets in the composition of concentrates initially have a high functional potential, which gradually decreases due to progressive spontaneous activation with a simultaneous decrease in reactivity and structural changes.

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Port Implantation in Patients with Severe Thrombocytopenia is Safe with Interventional Radiology

Keulers

Kiesow

Mahnken

2017

Cardiovasc Intervent Radiol

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2 Platelet Concentrates

Cited by 12 publications

References 63 publications

Association of Lumbar Puncture With Spinal Hematoma in Patients With and Without Coagulopathy

Association of Lumbar Puncture With Spinal Hematoma in Patients With and Without Coagulopathy

Morphofunctional state of platelets in their concentrates depending on storage time

Port Implantation in Patients with Severe Thrombocytopenia is Safe with Interventional Radiology

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