A prospective evaluation of platelet function in patients on antiplatelet therapy with traumatic intracranial hemorrhage

Bellal Joseph, Viraj Pandit, Moutamn Sadoun, Christopher G. Larkins, Narong Kulvatunyou, Andrew Tang, Matthew Mino, Randall S. Friese, Peter Rhee

Research output: Contribution to journalArticle

40 Scopus citations

Abstract

BACKGROUND: Platelet transfusion is increasingly used in patients with traumatic intracranial hemorrhage (ICH) on aspirin therapy to minimize the progression of ICH. We hypothesized (null) that platelet transfusion in this cohort of patients does not improve platelet function. METHODS: We performed a prospective interventional trail on patients with traumatic ICH on daily high-dose (325 mg) aspirin therapy. All patients received one pack of apheresis platelets. Blood samples were collected before and 1 hour after platelet transfusion. Platelet function was assessed using Verify Now Platelet Function Assay, and a cutoff of greater than 550 aspirin reaction units was used to define functioning platelets (FP). RESULTS: Twenty-eight patients were enrolled in the study. On presentation, 79% (22 of 28) of the patients had nonfunctioning platelets (NFPs), and transfusion of platelets did not improve platelet function as 81% (18 of 22) still had NFP. Of the 22 patients, 4 converted from NFP to FP after transfusion. There was no difference in the progression of ICH (37.5% vs. 30%, p = 0.7) or neurosurgical intervention (12.5% vs. 15%, p = 0.86) between patients with FP and NFP after platelet transfusion. CONCLUSION: Administration of one pack of apheresis platelet did not improve platelet function. In our study, progression of ICH and the need for neurosurgical intervention were independent of platelet function. Further randomized clinical trials are required to assess both the dose dependence effect and role of platelet transfusion in patients on antiplatelet therapy with traumatic ICH.

Original languageEnglish (US)
Pages (from-to)990-994
Number of pages5
JournalJournal of Trauma and Acute Care Surgery
Volume75
Issue number6
DOIs
StatePublished - Dec 1 2013

Keywords

  • Anti-platelet therapy
  • Platelet function
  • Platelet transfusion
  • Traumatic brain injury
  • VerifyNow platelet function assay

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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