A prospective study of platelet function in trauma patients

Ramsey, Matthew T.; Fabian, Timothy C.; Shahan, Charles P.; Sharpe, John P.; Mabry, Scott E.; Weinberg, Jordan A.; Croce, Martin A.; Jennings, Lisa K.

doi:10.1097/ta.0000000000001017

Cited by 72 publications

(61 citation statements)

References 26 publications

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“…Staining was performed according to the microscopy procedure (above). Forward scatter (FSC) signal, assumed to be proportional to cell size or cell volume, and side scatter (SSC) signal, related to the complexity of the cell (Ramsey et al, 2016), were collected and plotted against fluorescence from BODIPY 505/515 in the FITC-A channel.…”

Section: Materials and Methodsmentioning

confidence: 99%

The genome and phenome of the green alga Chloroidium sp. UTEX 3007 reveal adaptive traits for desert acclimatization

Nelson

Khraiwesh

et al. 2017

eLife

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To investigate the phenomic and genomic traits that allow green algae to survive in deserts, we characterized a ubiquitous species, Chloroidium sp. UTEX 3007, which we isolated from multiple locations in the United Arab Emirates (UAE). Metabolomic analyses of Chloroidium sp. UTEX 3007 indicated that the alga accumulates a broad range of carbon sources, including several desiccation tolerance-promoting sugars and unusually large stores of palmitate. Growth assays revealed capacities to grow in salinities from zero to 60 g/L and to grow heterotrophically on >40 distinct carbon sources. Assembly and annotation of genomic reads yielded a 52.5 Mbp genome with 8153 functionally annotated genes. Comparison with other sequenced green algae revealed unique protein families involved in osmotic stress tolerance and saccharide metabolism that support phenomic studies. Our results reveal the robust and flexible biology utilized by a green alga to successfully inhabit a desert coastline.DOI: http://dx.doi.org/10.7554/eLife.25783.001

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Section: Materials and Methodsmentioning

confidence: 99%

The genome and phenome of the green alga Chloroidium sp. UTEX 3007 reveal adaptive traits for desert acclimatization

Nelson

Khraiwesh

et al. 2017

eLife

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“…[12][13][14]36 Henriksen et al 26 showed that although platelet aggregation function declined over time after admission in severely injured patients, it was further reduced in those patients receiving blood products, with platelet transfusion associated with the most dramatic reduction in function. One potential proposed mechanism for this is the known poor platelet function of stored platelets.…”

Section: Discussionmentioning

confidence: 99%

“…10,11 Given the importance of endogenous platelets to hemostasis and their observed inability to function appropriately in severely injured patients, early platelet transfusions would seem intuitive. [12][13][14] Several retrospective studies and metaanalyses have demonstrated a benefit of platelet transfusions on outcomes in trauma patients. [15][16][17][18][19] These data are supported by 2 multicenter, prospective observational studies.…”

Section: Introductionmentioning

confidence: 99%

Platelet transfusions improve hemostasis and survival in a substudy of the prospective, randomized PROPPR trial

Xu²,

et al. 2018

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Key Points• Early platelet administration is associated with improved hemostasis and reduced mortality in severely injured, bleeding trauma patients.Transfusing platelets during massive hemorrhage is debated because of a lack of high-quality evidence concerning outcomes in trauma patients. The objective of this study was to examine the effect of platelet transfusions on mortality in severely injured trauma patients. This work analyzed PROPPR (Pragmatic, Randomized Optimal Platelet and Plasma Ratios) trial patients who received only the first cooler of blood products, which either did or did not contain platelets. Primary outcomes were all-cause mortality at 24 hours and 30 days and hemostasis.Secondary outcomes included cause of death, complications, and hospital-, intensive care unit (ICU)-, and ventilator-free days. Continuous variables were compared using Wilcoxon rank sum tests. Categorical variables were compared using Fisher's exact tests. There were 261 PROPPR patients who achieved hemostasis or died before receiving a second cooler of blood products (137 received platelets and 124 did not). Patients who received platelets also received more total plasma (median, 3 vs 2 U; P , .05) by PROPPR intervention design.There were no differences in total red blood cell transfusions between groups. After controlling for plasma volume, patients who received platelets had significantly decreased 24-hour (5.8% vs 16.9%; P , .05) and 30-day mortality (9.5% vs 20.2%; P , .05). More patients in the platelet group achieved hemostasis (94.9% vs 73.4%; P , .01), and fewer died as a result of exsanguination (1.5% vs 12.9%; P , .01). Patients who received platelets had a shorter time on mechanical ventilation (P , .05); however, no differences in hospital-or ICU-free days were observed. In conclusion, early platelet administration is associated with improved hemostasis and reduced mortality in severely injured, bleeding patients. This trial was registered at www.clinicaltrials.gov as # NCT01545232.

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“…Trauma-induced coagulation defect is a severe co-morbidity, strongly associated with an increased mortality [26]. Early therapy might also include platelet-directed treatments [27, 28]. …”

Section: Discussionmentioning

confidence: 99%

Clinical implications of fracture-associated vascular damage in extremity and pelvic trauma

Gilbert

Schneemann

Scholz

et al. 2018

BMC Musculoskelet Disord

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BackgroundVascular damage in polytrauma patients is associated with high mortality and morbidity. Therefore, specific clinical implications of vascular damage with fractures in major trauma patients are reassessed.MethodsThis comprehensive nine-year retrospective single center cohort study analyzed demography, laboratory, treatment and outcome data from 3689 patients, 64 patients with fracture-associated vascular injuries were identified and were compared to a control group.Results: Vascular damage occurred in 7% of patients with upper and lower limb and pelvic fractures admitted to the trauma room. Overall survival was 80% in pelvic fracture and 97% in extremity fracture patients and comparable to non-vascular trauma patients. Additional arterial damage required substantial fluid administration and was visible as significantly anemia and disturbed coagulation tests upon admission. Open procedures were done in over 80% of peripheral extremity vascular damage. Endovascular procedures were predominant (87%) in pelvic injury.ConclusionVascular damage is associated with high mortality rates especially in combination with pelvic fractures. Initial anemia, disturbed coagulation tests and the need for extensive pre-clinical fluid substitution were observed in the cohort with vascular damage. Therefore, fast diagnosis and early interventional and surgical procedures are necessary to optimize patient-specific outcome.Electronic supplementary materialThe online version of this article (10.1186/s12891-018-2333-y) contains supplementary material, which is available to authorized users.

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A prospective study of platelet function in trauma patients

Abstract: Prognostic and epidemiologic study, level III.

Cited by 72 publications

References 26 publications

The genome and phenome of the green alga Chloroidium sp. UTEX 3007 reveal adaptive traits for desert acclimatization

The genome and phenome of the green alga Chloroidium sp. UTEX 3007 reveal adaptive traits for desert acclimatization

Platelet transfusions improve hemostasis and survival in a substudy of the prospective, randomized PROPPR trial

Clinical implications of fracture-associated vascular damage in extremity and pelvic trauma

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