Background: Impaired ex vivo platelet aggregation is common in trauma patients. The mechanisms driving these impairments remain incompletely understood, but functional platelet exhaustion due to excessive in vivo activation is implicated. Given platelet adrenoreceptors and known catecholamine surges after injury, impaired ex vivo platelet aggregation in trauma patients may be linked to catecholamine-induced functional platelet exhaustion.
Objective: To determine the relationship of catecholamines with platelet-dependent hemostasis after injury and to model catecholamine-induced functional platelet exhaustion in healthy donor platelets.
Patients/methods: Whole blood was collected from 67 trauma patients as part of a prospective cohort study. Platelet aggregometry and rotational thromboelastometry were performed, and plasma epinephrine (EPI) and norepinephrine (NE) concentrations were measured. The effect of catecholamines on healthy donor platelets was examined in a microfluidic model, with platelet aggregometry, and by flow cytometry examining surface markers of platelet activation.
Results: In trauma patients, EPI and NE were associated with impaired platelet aggregation (both p < 0.05), and EPI was additionally associated with decreased viscoelastic clot strength, increased fibrinolysis, and mortality (all p < 0.05). In healthy donors, short duration incubation with EPI enhanced platelet aggregation, platelet adhesion under flow, and increased glycoprotein IIb/IIIa activation, while weaker effects were observed with NE. Compared with short incubation, longer incubation with EPI resulted in decreased platelet adhesion, platelet aggregation, and surface expression of glycoprotein IIb/IIIa.
Conclusions: These findings suggest sympathoadrenal activation in trauma patients contributes to impaired ex vivo platelet aggregation, which mechanistically may be explained by a functionally exhausted platelet phenotype under prolonged exposure to high plasma catecholamine levels.
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http://dx.doi.org/10.1111/jth.15763 | DOI Listing |
J Neurosurg Case Lessons
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Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.
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Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah.
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View Article and Find Full Text PDFPLoS One
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Data Science Center for the Study of Surgery, Injury and Equity in Africa (D-SINE-Africa), University of Buea, Buea, Cameroon.
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View Article and Find Full Text PDFPain
December 2024
Program in Dental Biomedical Sciences, School of Dentistry, University of Maryland Baltimore, Baltimore, MD, United States.
Temporomandibular disorder (TMD) is the most prevalent painful condition in the craniofacial area. Recent studies have suggested that external or intrinsic trauma to the temporomandibular joint (TMJ) is associated with the onset of painful TMD in patients. Here, we investigated the effects of TMJ trauma through forced-mouth opening (FMO) in mice to determine pain behaviors and peripheral sensitization of trigeminal nociceptors in both sexes.
View Article and Find Full Text PDFObjective: Aim: To reveal the essence of trauma-informed learning in the context of the functioning of a person's inner world and the impact on changing the levels of situational and personal anxiety.
Patients And Methods: Materials and Methods: The study involved 900 people who are pursuing higher education during the military operations on the territory of Ukraine. Two parts of the Spielberger State-Trait Anxiety Inventory (STAI) questionnaire were used to determine low, medium, and high levels of situational and personal anxiety.
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