Platelet function analysis utilising the PFA-100

Published Date: 16th August 2016

Publication Authors: Bolton N, , Bonney S, Tridente A, Nee PA

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Introduction

Sepsis is known to be associated with impaired platelet

function (1). The PFA-100 (Siemens Healthcare, Dade International, Miami, Fla., USA) is a device in which a citrated whole blood sample is aspirated through an aperture coated with agonists inducing platelet activation. Platelet aggregation leads to occlusion of the aperture and blood flow ceases over an interval termed the closure time (CT).

Aim

The aim of the present study was to determine whether CT, measured by the PFA-100, could be used to determine the likelihood of infection, sepsis, and bacteraemia or hospital mortality.

Methods

A single centre, prospective, observational cohort study.

Subjects were 101 pyrexial patients in a mixed adult ICU. Blood samples were drawn for cultures, full bloodcount, CRP and PFA analysis. Admission diagnosis, demographic data, laboratory variables, APACHE II scores and outcome data (infection, sepsis, bacteraemia and mortality) were collected from the clinical records. Logistic regression analysis was undertaken using Stata/IC (StataCorp, 4905 Lakeway Drive, College Station, Texas 77845 USA)

Results

Median age was 60 (Interquartile Range = IQR 46-71), 57

patients (56.4 %) were male, median APACHE II score was 16 (IQR 10-19). Of the recruited patients, 78 (77.2 %) had an infective process, and 70 (69.3 %) met SIRS criteria for sepsis; 12 patients (11.9 %) had positive blood cultures, 19 patients (18.8 %) did not survive to hospital discharge.

Logistic regression analysis, adjusted for age, gender and baseline APACHE II score found that CT did not predict any of the outcomes. Odd Ratios were 0.99 (95 % confidence interval = 95 % CI 0.98-1, p = 0.2) for infection, 0.99 (95 % CI 0.98-1, p = 0.37) for sepsis, 0.99 (95 % CI 0.98-1, p = 0.64) for bacteraemia and 1.00 (95 % CI 0.99-1.01, p = 0.71) for mortality, respectively.

Conclusions

Platelet aggregation measured by closure time utilising

the PFA-100 system did not correlate with infection, sepsis, bacteraemia or mortality in our sample of febrile patients.

Bolton, N; Dudziak, J; Bonney, S; Tridente, A; Nee, P. (2016). Platelet function analysis utilising the PFA-100 does not predict infection, bacteraemia, sepsis or outcome in critically ill patients​ . Critical Care. 20 (Suppl 2), 18-19

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