PB0883 - Platelet Function Testing in Sepsis

Background: Sepsis is defined as a “life-threatening organ dysfunction caused by a dysregulated host response to infection” (Sepsis-3). It is associated with a coagulopathy - disseminated intravascular coagulation (DIC) characterised by platelet consumption and the formation of micro-thrombi leading to ischemic damage.

Aims: The aim of this study is to characterise the potential of platelet activation as biomarkers of survival in sepsis.

Methods: Blood was collected from patients admitted to the critical care department of King Hamad University Hospital, Bahrain and control patients. Platelet function testing was performed using the Sinnowa PL-12 platelet function analyser and Innovance PFA-200.

Results: The mean age of the sepsis patients was 63 (54-67) years and 32 (27-47) years for the controls. The sepsis was 43% Gram-negative, 16% Gram-positive and 41% culture-negative.
The maximum aggregation rate (MAR) in response to ADP in the controls was 46.5 (30.5-60.6, IQR)% while in the cases it was 30.7 (22.5-49.7)%, p=0.046. The MAR in response to collagen was 49.4 (36.2-58.1)% in controls and 31.2 (20.2-44.3)% in sepsis cases, p=0.001. Patients with sepsis (n=25) had MAR to ADP of 43.9 (30.1-52.5)% and 25.6 (21.6-44.9), p=0.057 in those with septic shock (n=32) .
With arachidonic acid (AA) MAR was 48.2 (37.1-59) in sepsis patients and 23.7 (17.1-31.5)%, p< 0.001, in septic shock patients. Collagen MAR in survivors was 37.1 (23.9-46.5) n=40 and in non-survivors was 21 (18.6-39.9)%, n=17, p=0.038. In culture-positive sepsis collagen MAR was 27.2 (19.7-39.6)%, n=35 and in culture-negative sepsis 42.4 (22.7-53.5)%, n=22, p=0.029.
With the PFA-200 the only significant finding was using collagen-ADP cartridge where control patients had a closure time of 106 (88.5-129) sec and septic patients 125 (98.5-188.3) secs, p=0.027.

Conclusion(s): Platelet function testing using the Sinnowa PL-12 was effective at identifying patients with septic shock, especially those with culture-positive sepsis and non-survivors.