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The Role of Whole Blood Impedance Aggregometry and Its Utilisation in the Diagnosis and Prognosis of Patients with Systemic Inflammatory Response Syndrome and Sepsis in Acute Critical Illness

Gareth Davies Orcid Logo, Gavin M. Mills, Matthew Lawrence, Ceri Battle, Keith Morris, Karl Hawkins Orcid Logo, Phylip Rhodri Williams, Simon Davidson, Dafydd Thomas, Phillip Adrian Evans, Rhodri Williams Orcid Logo, Adrian Evans Orcid Logo

PLoS ONE, Volume: 9, Issue: 9, Start page: e108589

Swansea University Authors: Gareth Davies Orcid Logo, Matthew Lawrence, Karl Hawkins Orcid Logo, Rhodri Williams Orcid Logo, Adrian Evans Orcid Logo

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Abstract

ObjectiveTo assess the prognostic and diagnostic value of whole blood impedance aggregometry in patients with sepsis and SIRS and to compare with whole blood parameters (platelet count, haemoglobin, haematocrit and white cell count).MethodsWe performed an observational, prospective study in the acut...

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ISSN: 1932-6203
Published: 2014
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Platelet function was determined using whole blood impedance aggregometry (multiplate) on admission to the Emergency Department or Intensive Care Unit and at 6 and 24 hours post admission. Platelet count, haemoglobin, haematocrit and white cell count were also determined.Results106 adult patients that met SIRS and sepsis criteria were included. Platelet aggregation was significantly reduced in patients with severe sepsis/septic shock when compared to SIRS/uncomplicated sepsis (ADP: 90.7&#xB1;37.6 vs 61.4&#xB1;40.6; p&lt;0.001, Arachadonic Acid 99.9&#xB1;48.3 vs 66.3&#xB1;50.2; p&#x200A;=&#x200A;0.001, Collagen 102.6&#xB1;33.0 vs 79.1&#xB1;38.8; p&#x200A;=&#x200A;0.001; SD &#xB1; mean)). Furthermore platelet aggregation was significantly reduced in the 28 day mortality group when compared with the survival group (Arachadonic Acid 58.8&#xB1;47.7 vs 91.1&#xB1;50.9; p&lt;0.05, Collagen 36.6&#xB1;36.6 vs 98.0&#xB1;35.1; p&#x200A;=&#x200A;0.001; SD &#xB1; mean)). However haemoglobin, haematocrit and platelet count were more effective at distinguishing between subgroups and were equally effective indicators of prognosis. Significant positive correlations were observed between whole blood impedance aggregometry and platelet count (ADP 0.588 p&lt;0.0001, Arachadonic Acid 0.611 p&lt;0.0001, Collagen 0.599 p&lt;0.0001 (Pearson correlation)).ConclusionsReduced platelet aggregometry responses were not only significantly associated with morbidity and mortality in sepsis and SIRS patients, but also correlated with the different pathological groups. Whole blood aggregometry significantly correlated with platelet count, however, when we adjust for the different groups we investigated, the effect of platelet count appears to be non-significant.</abstract><type>Journal Article</type><journal>PLoS ONE</journal><volume>9</volume><journalNumber>9</journalNumber><paginationStart>e108589</paginationStart><publisher/><issnElectronic>1932-6203</issnElectronic><keywords/><publishedDay>30</publishedDay><publishedMonth>9</publishedMonth><publishedYear>2014</publishedYear><publishedDate>2014-09-30</publishedDate><doi>10.1371/journal.pone.0108589</doi><url/><notes>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permitsunrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</notes><college>COLLEGE NANME</college><department>Biomedical Sciences</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>BMS</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2019-10-14T12:22:07.8981401</lastEdited><Created>2015-05-06T15:20:14.6116632</Created><path><level id="1">College of Engineering</level><level id="2">Engineering</level></path><authors><author><firstname>Gareth</firstname><surname>Davies</surname><orcid>0000-0002-0863-9234</orcid><order>1</order></author><author><firstname>Gavin M.</firstname><surname>Mills</surname><order>2</order></author><author><firstname>Matthew</firstname><surname>Lawrence</surname><order>3</order></author><author><firstname>Ceri</firstname><surname>Battle</surname><order>4</order></author><author><firstname>Keith</firstname><surname>Morris</surname><order>5</order></author><author><firstname>Karl</firstname><surname>Hawkins</surname><orcid>0000-0003-0174-4151</orcid><order>6</order></author><author><firstname>Phylip Rhodri</firstname><surname>Williams</surname><order>7</order></author><author><firstname>Simon</firstname><surname>Davidson</surname><order>8</order></author><author><firstname>Dafydd</firstname><surname>Thomas</surname><order>9</order></author><author><firstname>Phillip Adrian</firstname><surname>Evans</surname><order>10</order></author><author><firstname>Rhodri</firstname><surname>Williams</surname><orcid>0000-0002-6912-5288</orcid><order>11</order></author><author><firstname>Adrian</firstname><surname>Evans</surname><orcid>0000-0002-0814-5162</orcid><order>12</order></author></authors><documents><document><filename>0021117-22072016095820.pdf</filename><originalFilename>davies2015v2.pdf</originalFilename><uploaded>2016-07-22T09:58:20.7670000</uploaded><type>Output</type><contentLength>830677</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><embargoDate>2016-07-22T00:00:00.0000000</embargoDate><documentNotes>Distributed under the terms of a Creative Commons Attribution (CC-BY-4.0)</documentNotes><copyrightCorrect>true</copyrightCorrect></document></documents><OutputDurs/></rfc1807>
spelling 2019-10-14T12:22:07.8981401 v2 21117 2015-05-06 The Role of Whole Blood Impedance Aggregometry and Its Utilisation in the Diagnosis and Prognosis of Patients with Systemic Inflammatory Response Syndrome and Sepsis in Acute Critical Illness 3959a373060151515e05594d4cbcd6b1 0000-0002-0863-9234 Gareth Davies Gareth Davies true false 262d0cae7663ded863d6e2de15757f3c Matthew Lawrence Matthew Lawrence true false 77c39404a9a98c6e2283d84815cba053 0000-0003-0174-4151 Karl Hawkins Karl Hawkins true false 642bf793695f412ed932f1ea4d9bc3f1 0000-0002-6912-5288 Rhodri Williams Rhodri Williams true false 21761f6eb805546a561c9f036e85405b 0000-0002-0814-5162 Adrian Evans Adrian Evans true false 2015-05-06 BMS ObjectiveTo assess the prognostic and diagnostic value of whole blood impedance aggregometry in patients with sepsis and SIRS and to compare with whole blood parameters (platelet count, haemoglobin, haematocrit and white cell count).MethodsWe performed an observational, prospective study in the acute setting. Platelet function was determined using whole blood impedance aggregometry (multiplate) on admission to the Emergency Department or Intensive Care Unit and at 6 and 24 hours post admission. Platelet count, haemoglobin, haematocrit and white cell count were also determined.Results106 adult patients that met SIRS and sepsis criteria were included. Platelet aggregation was significantly reduced in patients with severe sepsis/septic shock when compared to SIRS/uncomplicated sepsis (ADP: 90.7±37.6 vs 61.4±40.6; p<0.001, Arachadonic Acid 99.9±48.3 vs 66.3±50.2; p = 0.001, Collagen 102.6±33.0 vs 79.1±38.8; p = 0.001; SD ± mean)). Furthermore platelet aggregation was significantly reduced in the 28 day mortality group when compared with the survival group (Arachadonic Acid 58.8±47.7 vs 91.1±50.9; p<0.05, Collagen 36.6±36.6 vs 98.0±35.1; p = 0.001; SD ± mean)). However haemoglobin, haematocrit and platelet count were more effective at distinguishing between subgroups and were equally effective indicators of prognosis. Significant positive correlations were observed between whole blood impedance aggregometry and platelet count (ADP 0.588 p<0.0001, Arachadonic Acid 0.611 p<0.0001, Collagen 0.599 p<0.0001 (Pearson correlation)).ConclusionsReduced platelet aggregometry responses were not only significantly associated with morbidity and mortality in sepsis and SIRS patients, but also correlated with the different pathological groups. Whole blood aggregometry significantly correlated with platelet count, however, when we adjust for the different groups we investigated, the effect of platelet count appears to be non-significant. Journal Article PLoS ONE 9 9 e108589 1932-6203 30 9 2014 2014-09-30 10.1371/journal.pone.0108589 This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permitsunrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. COLLEGE NANME Biomedical Sciences COLLEGE CODE BMS Swansea University 2019-10-14T12:22:07.8981401 2015-05-06T15:20:14.6116632 College of Engineering Engineering Gareth Davies 0000-0002-0863-9234 1 Gavin M. Mills 2 Matthew Lawrence 3 Ceri Battle 4 Keith Morris 5 Karl Hawkins 0000-0003-0174-4151 6 Phylip Rhodri Williams 7 Simon Davidson 8 Dafydd Thomas 9 Phillip Adrian Evans 10 Rhodri Williams 0000-0002-6912-5288 11 Adrian Evans 0000-0002-0814-5162 12 0021117-22072016095820.pdf davies2015v2.pdf 2016-07-22T09:58:20.7670000 Output 830677 application/pdf Version of Record true 2016-07-22T00:00:00.0000000 Distributed under the terms of a Creative Commons Attribution (CC-BY-4.0) true
title The Role of Whole Blood Impedance Aggregometry and Its Utilisation in the Diagnosis and Prognosis of Patients with Systemic Inflammatory Response Syndrome and Sepsis in Acute Critical Illness
spellingShingle The Role of Whole Blood Impedance Aggregometry and Its Utilisation in the Diagnosis and Prognosis of Patients with Systemic Inflammatory Response Syndrome and Sepsis in Acute Critical Illness
Gareth Davies
Matthew Lawrence
Karl Hawkins
Rhodri Williams
Adrian Evans
title_short The Role of Whole Blood Impedance Aggregometry and Its Utilisation in the Diagnosis and Prognosis of Patients with Systemic Inflammatory Response Syndrome and Sepsis in Acute Critical Illness
title_full The Role of Whole Blood Impedance Aggregometry and Its Utilisation in the Diagnosis and Prognosis of Patients with Systemic Inflammatory Response Syndrome and Sepsis in Acute Critical Illness
title_fullStr The Role of Whole Blood Impedance Aggregometry and Its Utilisation in the Diagnosis and Prognosis of Patients with Systemic Inflammatory Response Syndrome and Sepsis in Acute Critical Illness
title_full_unstemmed The Role of Whole Blood Impedance Aggregometry and Its Utilisation in the Diagnosis and Prognosis of Patients with Systemic Inflammatory Response Syndrome and Sepsis in Acute Critical Illness
title_sort The Role of Whole Blood Impedance Aggregometry and Its Utilisation in the Diagnosis and Prognosis of Patients with Systemic Inflammatory Response Syndrome and Sepsis in Acute Critical Illness
author_id_str_mv 3959a373060151515e05594d4cbcd6b1
262d0cae7663ded863d6e2de15757f3c
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642bf793695f412ed932f1ea4d9bc3f1
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author_id_fullname_str_mv 3959a373060151515e05594d4cbcd6b1_***_Gareth Davies
262d0cae7663ded863d6e2de15757f3c_***_Matthew Lawrence
77c39404a9a98c6e2283d84815cba053_***_Karl Hawkins
642bf793695f412ed932f1ea4d9bc3f1_***_Rhodri Williams
21761f6eb805546a561c9f036e85405b_***_Adrian Evans
author Gareth Davies
Matthew Lawrence
Karl Hawkins
Rhodri Williams
Adrian Evans
author2 Gareth Davies
Gavin M. Mills
Matthew Lawrence
Ceri Battle
Keith Morris
Karl Hawkins
Phylip Rhodri Williams
Simon Davidson
Dafydd Thomas
Phillip Adrian Evans
Rhodri Williams
Adrian Evans
format Journal article
container_title PLoS ONE
container_volume 9
container_issue 9
container_start_page e108589
publishDate 2014
institution Swansea University
issn 1932-6203
doi_str_mv 10.1371/journal.pone.0108589
college_str College of Engineering
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hierarchy_top_id collegeofengineering
hierarchy_top_title College of Engineering
hierarchy_parent_id collegeofengineering
hierarchy_parent_title College of Engineering
department_str Engineering{{{_:::_}}}College of Engineering{{{_:::_}}}Engineering
document_store_str 1
active_str 0
description ObjectiveTo assess the prognostic and diagnostic value of whole blood impedance aggregometry in patients with sepsis and SIRS and to compare with whole blood parameters (platelet count, haemoglobin, haematocrit and white cell count).MethodsWe performed an observational, prospective study in the acute setting. Platelet function was determined using whole blood impedance aggregometry (multiplate) on admission to the Emergency Department or Intensive Care Unit and at 6 and 24 hours post admission. Platelet count, haemoglobin, haematocrit and white cell count were also determined.Results106 adult patients that met SIRS and sepsis criteria were included. Platelet aggregation was significantly reduced in patients with severe sepsis/septic shock when compared to SIRS/uncomplicated sepsis (ADP: 90.7±37.6 vs 61.4±40.6; p<0.001, Arachadonic Acid 99.9±48.3 vs 66.3±50.2; p = 0.001, Collagen 102.6±33.0 vs 79.1±38.8; p = 0.001; SD ± mean)). Furthermore platelet aggregation was significantly reduced in the 28 day mortality group when compared with the survival group (Arachadonic Acid 58.8±47.7 vs 91.1±50.9; p<0.05, Collagen 36.6±36.6 vs 98.0±35.1; p = 0.001; SD ± mean)). However haemoglobin, haematocrit and platelet count were more effective at distinguishing between subgroups and were equally effective indicators of prognosis. Significant positive correlations were observed between whole blood impedance aggregometry and platelet count (ADP 0.588 p<0.0001, Arachadonic Acid 0.611 p<0.0001, Collagen 0.599 p<0.0001 (Pearson correlation)).ConclusionsReduced platelet aggregometry responses were not only significantly associated with morbidity and mortality in sepsis and SIRS patients, but also correlated with the different pathological groups. Whole blood aggregometry significantly correlated with platelet count, however, when we adjust for the different groups we investigated, the effect of platelet count appears to be non-significant.
published_date 2014-09-30T03:31:30Z
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