naa a22 4500 510800246 CHVBK 20180411083352.0 cr unu---uuuuu 180411e20130401xx s 000 0 eng 10.1007/s12028-012-9745-6 doi (NATIONALLICENCE)springer-10.1007/s12028-012-9745-6 Platelet Dysfunction is an Early Marker for Traumatic Brain Injury-Induced Coagulopathy [Elektronische Daten] [Patrick Davis, Harsha Musunuru, Mark Walsh, Robert Cassady, Robert Yount, Andrew Losiniecki, Ernest Moore, Max Wohlauer, Janet Howard, Victoria Ploplis, Francis Castellino, Scott Thomas] Background: The goal of this study is to determine the presence of platelet dysfunction in patients with traumatic brain injury (TBI). The mechanisms underlying the coagulopathy associated with TBI remain elusive. The question of platelet dysfunction in TBI is unclear. Methods: This was a prospective observational study conducted at Memorial Hospital of South Bend, IN, and Denver Health Medical Center, CO. A total of 50 patients sustaining TBI, and not under treatment with anticoagulants or platelet inhibitors, were analyzed utilizing modified thromboelastography (TEG) with platelet mapping (TEG/PM), along with standard coagulation tests. Results: Compared to normal controls, patients with severe TBI had a significantly increased percentage of platelet ADP and arachidonic acid (AA) receptor inhibition. Furthermore, the percentage of ADP inhibition distinguished between survivors and non-survivors in patients with TBI (Mann-Whitney test, P=0.035). ADP inhibition correlates strongly with severity of TBI (Mann-Whitney test, P=0.014), while AA inhibition did not. Conclusion: These data indicate that early platelet dysfunction is prevalent after severe TBI, can be measured in a point-of-care setting using TEG/PM, and correlates with mortality. The mechanism responsible for this platelet dysfunction and associated implications for TBI management remains to be defined. Springer Science+Business Media, LLC, 2012 Traumatic Brain Injury (TBI) nationallicence Platelet function in TBI nationallicence Thromboelastography (TEG) nationallicence Thromboelastography modified platelet mapping (TEG/PM) nationallicence Coagulation nationallicence Coagulopathy of trauma nationallicence Davis Patrick W. M. Keck Center for Transgene Research, University of Notre Dame, 46556, Notre Dame, IN, USA aut Musunuru Harsha W. M. Keck Center for Transgene Research, University of Notre Dame, 46556, Notre Dame, IN, USA aut Walsh Mark W. M. Keck Center for Transgene Research, University of Notre Dame, 46556, Notre Dame, IN, USA aut Cassady Robert W. M. Keck Center for Transgene Research, University of Notre Dame, 46556, Notre Dame, IN, USA aut Yount Robert Memorial Hospital of South Bend, Emergency Trauma Center, 46601, South Bend, IN, USA aut Losiniecki Andrew Memorial Hospital of South Bend, Emergency Trauma Center, 46601, South Bend, IN, USA aut Moore Ernest Deparment of Surgery, University of Colorado, 80045, Denver, CO, USA aut Wohlauer Max Department of Surgery, Denver Health Medical Center, 8020, Denver, CO, USA aut Howard Janet Memorial Hospital of South Bend, Emergency Trauma Center, 46601, South Bend, IN, USA aut Ploplis Victoria W. M. Keck Center for Transgene Research, University of Notre Dame, 46556, Notre Dame, IN, USA aut Castellino Francis W. M. Keck Center for Transgene Research, University of Notre Dame, 46556, Notre Dame, IN, USA aut Thomas Scott Memorial Hospital of South Bend, Emergency Trauma Center, 46601, South Bend, IN, USA aut Neurocritical Care Humana Press Inc 18/2(2013-04-01), 201-208 1541-6933 18:2<201 2013 18 12028 https://doi.org/10.1007/s12028-012-9745-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-012-9745-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Davis Patrick W. M. Keck Center for Transgene Research, University of Notre Dame, 46556, Notre Dame, IN, USA aut NATIONALLICENCE 700 1- Musunuru Harsha W. M. Keck Center for Transgene Research, University of Notre Dame, 46556, Notre Dame, IN, USA aut NATIONALLICENCE 700 1- Walsh Mark W. M. Keck Center for Transgene Research, University of Notre Dame, 46556, Notre Dame, IN, USA aut NATIONALLICENCE 700 1- Cassady Robert W. M. Keck Center for Transgene Research, University of Notre Dame, 46556, Notre Dame, IN, USA aut NATIONALLICENCE 700 1- Yount Robert Memorial Hospital of South Bend, Emergency Trauma Center, 46601, South Bend, IN, USA aut NATIONALLICENCE 700 1- Losiniecki Andrew Memorial Hospital of South Bend, Emergency Trauma Center, 46601, South Bend, IN, USA aut NATIONALLICENCE 700 1- Moore Ernest Deparment of Surgery, University of Colorado, 80045, Denver, CO, USA aut NATIONALLICENCE 700 1- Wohlauer Max Department of Surgery, Denver Health Medical Center, 8020, Denver, CO, USA aut NATIONALLICENCE 700 1- Howard Janet Memorial Hospital of South Bend, Emergency Trauma Center, 46601, South Bend, IN, USA aut NATIONALLICENCE 700 1- Ploplis Victoria W. M. Keck Center for Transgene Research, University of Notre Dame, 46556, Notre Dame, IN, USA aut NATIONALLICENCE 700 1- Castellino Francis W. M. Keck Center for Transgene Research, University of Notre Dame, 46556, Notre Dame, IN, USA aut NATIONALLICENCE 700 1- Thomas Scott Memorial Hospital of South Bend, Emergency Trauma Center, 46601, South Bend, IN, USA aut NATIONALLICENCE 773 0- Neurocritical Care Humana Press Inc 18/2(2013-04-01), 201-208 1541-6933 18:2<201 2013 18 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer